Walnut Creek Pediatric Medical GRP

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

WALNUT CREEK PEDIATRIC MEDICAL GRP

Practice address

1822 San Miguel Drive
Walnut Creek, CA 94596

Phone

(925) 945-3580

Fax

(925) 934-0471

NPI assigned

Jul 17, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Montgomery Lawton Kong, M.D.NPI 1942219928

Title

Physician

Phone

(925) 945-3580

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Montgomery Lawton Kong, MD

  • Pediatrics Physician
  • Walnut Creek, CA
  • NPI 1942219928
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275550030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1822 SAN MIGUEL DRIVE",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "94596",
            "telephone_number": "925-945-3580",
            "fax_number": "925-934-0471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1822 SAN MIGUEL DRIVE",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "94596",
            "telephone_number": "925-945-3580",
            "fax_number": "925-934-0471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALNUT CREEK PEDIATRIC MEDICAL GRP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KONG",
        "authorized_official_first_name": "MONTGOMERY",
        "authorized_official_middle_name": "LAWTON",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "925-945-3580",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walnut Creek Modern Dentistry, Prof. Corp. (Walnut Creek Modern Dentistry)
• Walnut Creek Optical
• Walnut Creek Optical
• Walnut Creek Optometry Group
• Walnut Creek Orthopedics and Sports Medicine, Professional Corporation
• Walnut Creek RX LLC (Qd Pharmacy)
• Walnut Creek RX LLC (QD Pharmacy)
• Walnut Creek Surgery Center LLC
• Walnut Creek Surgical Assoicates, Inc
• Walnut Creek Urgent Care

• Pediatrics Physician in Walnut Creek, CA
• Providers in Walnut Creek, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.