Montefusco, Anthony Michael

Montefusco, Anthony Michael is an individual health care provider with primary practice located at 13855 E 14Th St , San Leandro CA 94578-2611. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Montefusco, Anthony Michael can be contacted via phone (209) 342-2300.

Contact Information

Primary practice address
13855 E 14Th St San Leandro CA 94578-2611
Phone: (209) 342-2300
Fax: (209) 524-4240
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X A65978 California

Profile Details

NPI number 1104817972
LBN Legal business name Montefusco, Anthony Michael
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 2nd, 2005
Last updated May 28th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104817972 NPPES
California Other 00A659780 BLUE SHIELD
California MEDICAID 00A659780 BLUE SHIELD

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