Individual
ESTEBAN MONGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1489 TABER DR, CHULA VISTA, CA 91911-7037
(408) 768-9469
Mailing address
1489 TABER DR, CHULA VISTA, CA 91911-7037
(408) 768-9469
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
2255A2300X
Athletic Trainer
Primary
—
—
246Z00000X
Other Specialist/Technologist
—
—
Other
Enumeration date
10/24/2016
Last updated
10/24/2016
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