Doctor Name: | WILLIAM JOHN MONTGOMERY |
NPI Number: | 1033139266 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | G72529 |
Business Practice Address: | 400 N Pepper Ave Colton, CA - 923241801 |
Business Phone Number: | 9095806353 |
Business Fax Number: | 9095806369 |
Mailing Address: | Po Box 8520, REDLANDS |
State: | CA |
Postal Code: | 923751720 |
Phone Number: | 9095571600 |
Fax Number: | 9095571740 |
NPI Enumeration Date: | 07/20/2006 |
NPI Last Update Date: | 07/13/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | G72529 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |