Individual
MONTRA M KANOK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1030 E FOOTHILL BLVD, STE 101, UPLAND, CA 91786
(909) 981-5859
(909) 981-8293
Mailing address
1030 E FOOTHILL BLVD, STE 101, UPLAND, CA 91786
(909) 981-5859
(909) 981-8293
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
A25649
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A256490
—
CA
01
—
A25649
LIC
CA
Enumeration date
05/10/2006
Last updated
03/07/2023
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