Provider Demographics
NPI:1407098171
Name:MONTES-SHAW, MARIANA ELENA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIANA
Middle Name:ELENA
Last Name:MONTES-SHAW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARIANA
Other - Middle Name:
Other - Last Name:MONTES DE SHAW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:447 N EL MOLINO AVE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-1403
Mailing Address - Country:US
Mailing Address - Phone:626-577-8480
Mailing Address - Fax:626-577-8978
Practice Address - Street 1:447 N EL MOLINO AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-1403
Practice Address - Country:US
Practice Address - Phone:626-577-8480
Practice Address - Fax:626-577-8978
Is Sole Proprietor?:No
Enumeration Date:2009-03-27
Last Update Date:2015-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner