Individual
MATTHEW BRIAN MONTIEL LACANILAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1009 LAUREL RD, SANTA PAULA, CA 93060-1231
(805) 258-9336
Mailing address
1009 LAUREL RD, SANTA PAULA, CA 93060-1231
(805) 258-9336
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
95121166
CA
Other
Enumeration date
01/27/2020
Last updated
01/27/2020
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