Individual provider Active NPI

Wendy Caroline Monteon, PA-C

  • Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1053657791
Registry record updated Jul 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA22689 Issued in CA
Practice address
3834 S Western Ave
Los Angeles, CA 90062-1104
Phone
(323) 730-1920
Fax
(323) 730-1820
NPI assigned
Dec 28, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA22689 CA Primary

Addresses

Primary practice location

3834 S Western Ave
Los Angeles, CA 90062-1104

Mailing address

3834 S Western Ave
Los Angeles, CA 90062-1104
Phone (323) 730-1920

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160518000907 CA Order and Referring Only - Physician Assistant 9032408836

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA22689CAMDPhysician Assistant

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

NPI Registry JSON

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

{
    "created_epoch": "1356652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374105600000",
    "number": "1053657791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3834 S WESTERN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900621104",
            "telephone_number": "323-730-1920",
            "fax_number": "323-730-1820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3834 S WESTERN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900621104",
            "telephone_number": "323-730-1920",
            "fax_number": "323-730-1820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTEON",
        "first_name": "WENDY",
        "middle_name": "CAROLINE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-28",
        "last_updated": "2013-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA22689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.