Organization
B. L. MONTGOMERY M.D., INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BLAINE LEWIS MONTGOMERY MD (PRESIDENT)
(310) 377-2635
Entity
Organization
Contact information
Practice address
6833 ABBOTTSWOOD DR, RANCHO PALOS VERDES, CA 90275-3058
(310) 377-2635
Mailing address
6833 ABBOTTSWOOD DR, RANCHO PALOS VERDES, CA 90275-3058
(310) 377-2635
Taxonomy
Speciality
Code
Description
License number
State
261QR0206X
Mammography Clinic/Center
Primary
A28710
CA
Other
Enumeration date
08/13/2009
Last updated
08/13/2009
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