# MONTE VISTA MEDICAL GROUP, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083338826
- **Authorized official:** AMY BAUTISTA NP (CFO/SECRETARY)
- **Authorized official phone:** (909) 230-0101

## Contact information

- **Practice address:** 9655 MONTE VISTA AVE STE 405, MONTCLAIR, CA 91763-2238
- **Practice address phone:** (909) 230-0101
- **Practice address fax:** (909) 445-1122
- **Mailing address:** 9655 MONTE VISTA AVE STE 405, MONTCLAIR, CA 91763-2238
- **Mailing address phone:** (909) 230-0101
- **Mailing address fax:** (909) 445-1122

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/26/2022
- **Last updated:** 09/26/2022