Provider Demographics
NPI:1871296301
Name:MONTGOMERY, CHRISTOPHER RYAN BOECKMANN (MPH, MD)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:RYAN BOECKMANN
Last Name:MONTGOMERY
Suffix:
Gender:M
Credentials:MPH, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1100 GLENDON AVE STE 1200
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-3516
Mailing Address - Country:US
Mailing Address - Phone:310-794-0785
Mailing Address - Fax:310-794-0599
Practice Address - Street 1:757 WESTWOOD PLZ
Practice Address - Street 2:EMERGENCY MEDICINE
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-7419
Practice Address - Country:US
Practice Address - Phone:310-794-0785
Practice Address - Fax:310-794-0599
Is Sole Proprietor?:No
Enumeration Date:2023-03-23
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program