Provider Demographics
NPI:1265079198
Name:MONROY, JOEL LUIS
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:LUIS
Last Name:MONROY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1048 PLAYA DEL NORTE
Mailing Address - Street 2:
Mailing Address - City:CALEXICO
Mailing Address - State:CA
Mailing Address - Zip Code:92231-4520
Mailing Address - Country:US
Mailing Address - Phone:760-357-0480
Mailing Address - Fax:
Practice Address - Street 1:1048 PLAYA DEL NORTE
Practice Address - Street 2:
Practice Address - City:CALEXICO
Practice Address - State:CA
Practice Address - Zip Code:92231-4520
Practice Address - Country:US
Practice Address - Phone:760-357-0480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-10
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other