Provider Demographics
NPI:1518539485
Name:MONTAR, CARLOS JOEL
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:JOEL
Last Name:MONTAR
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:PO BOX 907
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93456-0907
Mailing Address - Country:US
Mailing Address - Phone:805-720-2242
Mailing Address - Fax:
Practice Address - Street 1:507 EL NIDO CT
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93455-1745
Practice Address - Country:US
Practice Address - Phone:805-720-2242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-12
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program