Individual
RICHARD CHRISTIAN MONTENEGRO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1388 S NAVAJO ST, SALT LAKE CITY, UT 84104-3493
(801) 955-2360
Mailing address
2621 S 3270 W, WEST VALLEY CITY, UT 84119-1119
(385) 261-2737
(801) 746-0420
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0248578
STUDENT ID
UT
Enumeration date
10/10/2018
Last updated
11/27/2019
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