Provider Demographics
NPI:1194871376
Name:MONTENEGRO, BRIAN LEONARDO (MD)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:LEONARDO
Last Name:MONTENEGRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:NORTHBAY NEONATOLOGY ASSOCIATES, INC
Mailing Address - Street 2:1860 PENNSYLVANIA AVE, STE 145
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-3547
Mailing Address - Country:US
Mailing Address - Phone:707-646-4052
Mailing Address - Fax:
Practice Address - Street 1:NORTHBAY MEDICAL CENTER
Practice Address - Street 2:1200 B GALE WILSON BLVD
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-3552
Practice Address - Country:US
Practice Address - Phone:707-646-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-28
Last Update Date:2025-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1135922080N0001X, 208000000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine