Provider Demographics
NPI:1275424848
Name:MONTALTO, TINA (IBCLC, LMT, MLDT)
Entity type:Individual
Prefix:MISS
First Name:TINA
Middle Name:
Last Name:MONTALTO
Suffix:
Gender:F
Credentials:IBCLC, LMT, MLDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3208 SILVERADO DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90039-2510
Mailing Address - Country:US
Mailing Address - Phone:646-423-7586
Mailing Address - Fax:
Practice Address - Street 1:3208 SILVERADO DR
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90039-2510
Practice Address - Country:US
Practice Address - Phone:646-423-7586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-11
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL-316785174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN