Individual
OCTAVIO MARQUEZ MONTOYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1200 ROSECRANS AVE STE 206, MANHATTAN BEACH, CA 90266-2451
(310) 726-0750
Mailing address
355 E 103RD ST, LOS ANGELES, CA 90003-4903
(323) 696-5418
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/22/2019
Last updated
06/22/2019
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