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Individual

MICHAEL JESSE MONGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RT

Contact information

Practice address
6522 BUFFALO AVE, VALLEY GLEN, CA 91401-1703
(818) 271-4285
Mailing address
6522 BUFFALO AVE, VALLEY GLEN, CA 91401-1703
(818) 271-4285

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
RHF00108634
CA
247100000X
Radiologic Technologist
Primary
RHF00108634
CA

Other

Enumeration date
04/21/2022
Last updated
04/21/2022
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