Charles H Montgomery, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A69876 Issued in CA

Practice address

111 Deerwood Rd
Suite 360
San Ramon, CA 94583-4409

Phone

(925) 736-8584

Fax

(925) 886-3306

NPI assigned

Dec 31, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1167523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672358400000",
    "number": "1689730772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 DEERWOOD RD STE 360",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945834446",
            "telephone_number": "925-594-1177",
            "fax_number": "925-886-3306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 DEERWOOD RD",
            "address_2": "SUITE 360",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945834409",
            "telephone_number": "925-736-8584",
            "fax_number": "925-886-3306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "CHARLES",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-31",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "A69876",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A69876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marina N Momenzai
• Kailey Monday
• Alma Cristal Monge Ortega
• Zoe Moniz
• Adriana Montano
• Benjamin Montiel
• Yukyung Moon, DDS
• Priyanka Moonka, D.D.S.
• Cristina Moore, M.S.
• Mary Moore, PHARM.D.

• Psychiatry Physician in San Ramon, CA
• Providers in San Ramon, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.