Provider Demographics
NPI:1073386819
Name:BELMONT, NAICHEZ JOSIAH
Entity Type:Individual
Prefix:
First Name:NAICHEZ
Middle Name:JOSIAH
Last Name:BELMONT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7651 EL MONTE DR
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90620-2501
Mailing Address - Country:US
Mailing Address - Phone:714-235-3931
Mailing Address - Fax:
Practice Address - Street 1:7651 EL MONTE DR
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90620-2501
Practice Address - Country:US
Practice Address - Phone:714-235-3931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18240225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist