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Individual

DR. ANDY RICHARD MONTALVO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
1955 BROADWAY, OAKLAND, CA 94612-2205
(510) 832-0251
(510) 832-0252
Mailing address
1351 ISABELLE CIR, SOUTH SAN FRANCISCO, CA 94080-7517
(650) 992-7003

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
10718T
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
SD0107180
CA
Enumeration date
11/26/2006
Last updated
07/08/2007
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