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Organization
LUZVIMINDA T MONTECILLO MD A PROFESSIONAL CORPORATION
Active
Organization
LUZVIMINDA T MONTECILLO MD A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OSCAR TAGORDA DO (OFFICE MANAGER)
(310) 673-2764
Entity
Organization
Contact information
Practice address
645 AERICK STREET, SUITE 1, INGLEWOOD, CA 90301-4882
(310) 673-2764
(310) 673-2403
Mailing address
645 AERICK ST STE 1, INGLEWOOD, CA 90301-4882
(310) 673-2764
(310) 673-2403
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A52290
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A522900
—
CA
Enumeration date
11/01/2006
Last updated
03/18/2020
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