Provider Demographics
NPI:1821259334
Name:F. MONTELONGO M.D INC
Entity Type:Organization
Organization Name:F. MONTELONGO M.D INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FERNANDO
Authorized Official - Middle Name:A
Authorized Official - Last Name:MONTELONGO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-997-8050
Mailing Address - Street 1:932 E CHAPMAN AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92866-2109
Mailing Address - Country:US
Mailing Address - Phone:714-997-8050
Mailing Address - Fax:714-997-5075
Practice Address - Street 1:932 E CHAPMAN AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92866-2109
Practice Address - Country:US
Practice Address - Phone:714-997-8050
Practice Address - Fax:714-997-5075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-18
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG45460OtherLICENSE