Green, Gary M.

Green, Gary M. is an individual health care provider with primary practice located at 34 Mark West Springs Rd Fl 3 , Santa Rosa CA 95403. He recently has only one registered license in Allopathic & Osteopathic Physicians / Infectious Disease, which is considered as his primary health care specialty. Green, Gary M. can be contacted via phone (707) 573-5234.

Contact Information

Primary practice address
34 Mark West Springs Rd Fl 3 Santa Rosa CA 95403
Phone: (707) 573-5234
Fax: (707) 573-5438
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Infectious Disease 207RI0200X G80599 California

Profile Details

NPI number 1124102108
LBN Legal business name Green, Gary M.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 25th, 2006
Last updated Sep 25th, 2019 - about 5 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 1124102108 NPPES
California MEDICAID 00G805990
California Other G80599

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