Individual ProviderEdwin MontemayorBehavior TechnicianBehavioral Health & Social Service ProvidersPractice Address9620 Chesapeake Dr Ste 105, San Diego, CA 92123-1324(714) 460-3170PECOS EnrollmentBased on the most recent information from CMS, provider Edwin Montemayor does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1225621931Provider TypeIndividualFull NameMontemayor, EdwinGenderMaleSole ProprietorNoEnumeration Date2/12/2021Last Updated2/12/2021Contact InformationPractice LocationPractice Address9620 Chesapeake Dr Ste 105, San Diego, CA 92123-1324Phone(714) 460-3170FaxUnlisted FaxMailing LocationMailing Address9620 Chesapeake Dr Ste 105, San Diego, CA 92123-1324PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106S00000XPrimaryDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicenseRBT-18-72549California