Individual provider Active NPI

Michael Lawrence Montez, MS, ATC, CSCS

  • Athletic Trainer
  • Los Angeles, CA
National Provider Identifier
1053438309
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
02042142 Issued in CA
Practice address
1500 San Pablo St.
Usc University Hospital Sports Med.
Los Angeles, CA 90033
Phone
(323) 442-5226
Fax
(323) 442-8750
NPI assigned
Mar 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 02042142 CA Primary

Addresses

Primary practice location

1500 San Pablo St.
Usc University Hospital Sports Med.
Los Angeles, CA 90033

Mailing address

4317 E 4TH St Apt 4
Long Beach, CA 90814-0952
Phone (562) 930-9049

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
02042142CAMDAthletic Trainer

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053438309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4317 E 4TH ST APT 4",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908140952",
            "telephone_number": "562-930-9049",
            "fax_number": "323-442-8750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 SAN PABLO ST.",
            "address_2": "USC UNIVERSITY HOSPITAL SPORTS MED.",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90033",
            "telephone_number": "323-442-5226",
            "fax_number": "323-442-8750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTEZ",
        "first_name": "MICHAEL",
        "middle_name": "LAWRENCE",
        "name_prefix": "Mr.",
        "credential": "MS, ATC, CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "CA",
            "license": "02042142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.