Organization
FCS - MONTEBELLO
Active
Parent organization
MEDVANTX, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
MAURICIO EDUARDO BUENO MD (MEDICAL DIRECTOR)
(323) 791-0557
Entity
Organization
Contact information
Practice address
815 WASHINGTON BLVD, MONTEBELLO, CA 90640-6123
(323) 728-3955
Mailing address
5626 OBERLIN DR STE 110, SAN DIEGO, CA 92121-1705
(323) 317-9200
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
G52360
CA
Other
Enumeration date
04/29/2008
Last updated
03/31/2026
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