Provider Demographics
NPI:1861622698
Name:MONTERO, JOSEPH ALEXIS (OD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:ALEXIS
Last Name:MONTERO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6629 SUMMER RAIN WAY
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95621-6313
Mailing Address - Country:US
Mailing Address - Phone:916-600-3914
Mailing Address - Fax:
Practice Address - Street 1:1245 W WARM SPRINGS RD
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-8740
Practice Address - Country:US
Practice Address - Phone:702-938-8025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-14
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV642152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist