Green, David Michael

Green, David Michael is an individual health care provider with primary practice located at 3549 Camino Del Rio S Suite D, San Diego CA 92108-4023. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Forensic. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Green, David Michael can be contacted via phone (619) 281-0616.

Contact Information

Primary practice address
3549 Camino Del Rio S Suite D San Diego CA 92108-4023
Phone: (619) 281-0616
Fax: (619) 528-1263
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY4696 California
Behavioral Health & Social Service Providers / Forensic 103TF0200X PSY4696 California

Profile Details

NPI number 1457417685
LBN Legal business name Green, David Michael
Credentials PH.D
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 30th, 2006
Last updated Jul 8th, 2007 - about 18 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 1457417685 NPPES
California MEDICAID YYY49122Y

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