Montgomery, Russell Scott

Montgomery, Russell Scott is an individual health care provider with primary practice located at 1211 W La Palma Ave Suite 505, Anaheim CA 92801-2815. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Montgomery, Russell Scott can be contacted via phone (714) 778-1032.

Contact Information

Primary practice address
1211 W La Palma Ave Suite 505 Anaheim CA 92801-2815
Phone: (714) 778-1032
Fax: (714) 778-5634
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X G81733 California

Profile Details

NPI number 1386624526
LBN Legal business name Montgomery, Russell Scott
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 20th, 2006
Last updated Jul 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386624526 NPPES
Arkansas MEDICAID GR0093510
Arkansas MEDICAID 00G817330

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