Active NPI
Charles Kenneth Metzger, MD MBA
- Urology Physician
- Glendora, CA
National Provider Identifier
1992796411
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- G25299
- Practice address
- 412 W Carroll Ave
Ste 200
Glendora, CA 91741-4240 - Phone
- (626) 335-0228
- Fax
- (626) 914-9611
- NPI assigned
- Nov 3, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | G25299 | CA | Primary |
Addresses
Primary practice location
412 W Carroll Ave
Ste 200
Glendora, CA 91741-4240
Mailing address
412 W Carroll Ave
Ste 200
Glendora, CA 91741-4240
Phone (626) 335-0228
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZZ72637Z | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Business Administration, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G25299 | CA | MD | Urology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1992796411",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "412 W CARROLL AVE",
"address_2": "STE 200",
"city": "GLENDORA",
"state": "CA",
"postal_code": "917414240",
"telephone_number": "626-335-0228",
"fax_number": "626-914-9611"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "412 W CARROLL AVE",
"address_2": "STE 200",
"city": "GLENDORA",
"state": "CA",
"postal_code": "917414240",
"telephone_number": "626-335-0228",
"fax_number": "626-914-9611"
}
],
"practiceLocations": [],
"basic": {
"last_name": "METZGER",
"first_name": "CHARLES",
"middle_name": "KENNETH",
"name_prefix": "Dr.",
"credential": "MD MBA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-03",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "CA",
"license": "G25299",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ZZZ72637Z",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Glendora, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.