Provider Demographics
NPI:1326219783
Name:MONTANEZ, ALICIA (MD)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:MONTANEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1211 W LA PALMA AVE STE 408
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-2806
Mailing Address - Country:US
Mailing Address - Phone:714-353-3250
Mailing Address - Fax:714-386-5350
Practice Address - Street 1:1211 W LA PALMA AVE STE 408
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-2806
Practice Address - Country:US
Practice Address - Phone:714-353-3250
Practice Address - Fax:714-386-5350
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-13
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA97240207RC0001X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease