Green, Gary Alan

Green, Gary Alan is an individual health care provider with primary practice located at 881 Alma Real Dr Ste 101 , Pacific Palisades CA 90272-3792. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Green, Gary Alan can be contacted via phone (310) 829-8923.

Contact Information

Primary practice address
881 Alma Real Dr Ste 101 Pacific Palisades CA 90272-3792
Phone: (310) 829-8923
Fax: (424) 212-5936
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X G63969 California

Profile Details

NPI number 1154345254
LBN Legal business name Green, Gary Alan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 26th, 2006
Last updated Feb 13th, 2024 - about last year

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 1154345254 NPPES
California MEDICAID 00G639690

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