Individual
VICENTE JOSE UNDURRAGA PERL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 W BROADWAY ST FL 4, MISSOULA, MT 59802-4008
(406) 329-5828
(406) 329-5864
Mailing address
PO BOX 31001-4110, PASADENA, CA 91110-4110
(406) 329-5828
(406) 329-5864
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
M-14232
ID
2086S0102X
Surgical Critical Care Physician
Primary
MED-PHYS-LIC-113704
MT
Other
Enumeration date
04/29/2010
Last updated
06/03/2025
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