Provider Demographics
NPI:1699249151
Name:MONTANO, ALAN RAY
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:RAY
Last Name:MONTANO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1145 MARKET ST FL 10
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-1566
Mailing Address - Country:US
Mailing Address - Phone:415-552-7914
Mailing Address - Fax:
Practice Address - Street 1:1145 MARKET ST FL 10
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-1566
Practice Address - Country:US
Practice Address - Phone:415-552-7914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-17
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker