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NPI Code Detail

MEDICARE: DR. ROBERT LANCE MONTGOMERY M.D.

MEDICARE: DR. ROBERT LANCE MONTGOMERY M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207XS0114XAdult Reconstructive Orthopaedic Surgery PhysicianG65982CA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3RR2000 33606OTHERCAMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
200G659820G89OTHERCACAL-OPTIMA

General Provider Information

NPI Number : 1952304594
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT LANCE MONTGOMERY M.D.
Provider Business Mailing Address
First Line : 24331 EL TORO RD STE 200
Second Line :
City : LAGUNA WOODS
State : CA
Zip : 92637-3116
Country : US
Telephone Number : 949-586-3200
Fax Number : 949-900-2116
Provider Business Practice Location Address
First Line : 24331 EL TORO RD STE 200
Second Line :
City : LAGUNA WOODS
State : CA
Zip : 92637-3116
Country : US
Telephone Number : 949-586-3200
Fax Number : 949-900-2116
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2005
Last Update Date : 06/29/2020

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