Provider Demographics
NPI:1285825018
Name:MOUNTS, TROY I (MD)
Entity Type:Individual
Prefix:
First Name:TROY
Middle Name:I
Last Name:MOUNTS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1737
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93406-1737
Mailing Address - Country:US
Mailing Address - Phone:805-544-2500
Mailing Address - Fax:805-544-0832
Practice Address - Street 1:5000 SAN PALO RD
Practice Address - Street 2:
Practice Address - City:ATASCADERO
Practice Address - State:CA
Practice Address - Zip Code:93422-2481
Practice Address - Country:US
Practice Address - Phone:805-544-2500
Practice Address - Fax:805-544-0832
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA132322207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1548664717OtherGROUP NPI