Individual provider Active NPI

Manuel Montemayor, MD

  • General Practice Physician
  • San Marcos, CA
National Provider Identifier
1609918978
Registry record updated Jan 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A51037 Issued in CA
Practice address
727 W San Marcos Blvd
Suite 112
San Marcos, CA 92078-1244
Phone
(760) 736-8810
Fax
(760) 736-3157
NPI assigned
Feb 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X A51037 CA Primary

Addresses

Primary practice location

727 W San Marcos Blvd
Suite 112
San Marcos, CA 92078-1244

Mailing address

727 W San Marcos Blvd
Suite 112
San Marcos, CA 92078-1244
Phone (760) 736-8810

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
51037CAMDPharmacist
A51037CAMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421971200000",
    "number": "1609918978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "727 W SAN MARCOS BLVD",
            "address_2": "SUITE 112",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920781244",
            "telephone_number": "760-736-8810",
            "fax_number": "760-736-3157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 W SAN MARCOS BLVD",
            "address_2": "SUITE 112",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920781244",
            "telephone_number": "760-736-8810",
            "fax_number": "760-736-3157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTEMAYOR",
        "first_name": "MANUEL",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2015-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A51037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Marcos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2015; 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.