Basic Information
| Provider Information | |||||||||
| NPI: | 1366864126 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STONG | ||||||||
| FirstName: | MONT | ||||||||
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| Credential: | AU.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 80 COLLINGWOOD ST | ||||||||
| Address2: | APT 201 | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941141997 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4154040065 | ||||||||
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| Practice Location | |||||||||
| Address1: | 450 SUTTER ST | ||||||||
| Address2: | RM 934 | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941153997 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4153622901 | ||||||||
| FaxNumber: | 4153622429 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/14/2014 | ||||||||
| LastUpdateDate: | 01/14/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | DAU1201 | CA | Y | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.