Green, Charles Gary

Green, Charles Gary is an individual health care provider with primary practice located at 60 Hall Street , Susanville CA 96130. He recently has only one registered license in Allopathic & Osteopathic Physicians / Body Imaging, which is considered as his primary health care specialty. Green, Charles Gary can be contacted via phone (530) 257-6010.

Contact Information

Primary practice address
60 Hall Street Susanville CA 96130
Phone: (530) 257-6010
Fax: (530) 257-6038
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Body Imaging 2085B0100X G46958 California

Profile Details

NPI number 1073698189
LBN Legal business name Green, Charles Gary
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 26th, 2006
Last updated Jul 8th, 2007 - about 17 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 1073698189 NPPES
California MEDICAID 00G469582
California Other 5424723
California Other 00G469580

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