Doctor Name: | GORDON JAMES MONTGOMERY |
NPI Number: | 1144226234 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | G31591 |
Business Practice Address: | 655 Euclid Ave Ste 302 National City, CA - 919502957 |
Business Phone Number: | 6194721010 |
Business Fax Number: | 6194795233 |
Mailing Address: | 655 Euclid Ave, Ste 302 NATIONAL CITY |
State: | CA |
Postal Code: | 919502957 |
Phone Number: | 6194721010 |
Fax Number: | 6194795233 |
NPI Enumeration Date: | 06/23/2005 |
NPI Last Update Date: | 02/12/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | 04/05/2006 |
NPI Reactivation Date: | 04/05/2006 |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | G31591 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |