Green, Geoffrey Riley
Green, Geoffrey Riley is an individual health care provider with primary practice located at 1100 West Stewart Drive , Orange CA 92868-3849. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Green, Geoffrey Riley can be contacted via phone (714) 633-9111.Contact Information
Primary practice address
1100 West Stewart Drive
Orange CA 92868-3849
Phone: (714) 633-9111
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | PA17453 | California |
Profile Details
| NPI number | 1306878533 |
|---|---|
| LBN Legal business name | Green, Geoffrey Riley |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 7th, 2006 |
| Last updated | Jan 13th, 2010 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306878533 | NPPES |
| California | MEDICAID | PA17453 |
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