Individual provider Active NPI

Charles Kenneth Metzger, MD MBA

  • Urology Physician
  • Glendora, CA
National Provider Identifier
1992796411
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
G25299 Issued in CA
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

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
ZZZ72637ZMedicaidCA

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

LicenseStateTypeSpecialty
G25299CAMDUrology 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.

Verify at the official NPI Registry.