Greene, David A

Greene, David A is an individual health care provider with primary practice located at 5555 Montgomery Dr , Santa Rosa CA 95409-8846. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Geriatric Medicine. Allopathic & Osteopathic Physicians / Geriatric Medicine is his primary health care specialty. Greene, David A can be contacted via phone (707) 579-6957.

Contact Information

Primary practice address
5555 Montgomery Dr Santa Rosa CA 95409-8846
Phone: (707) 579-6957
Fax: (707) 579-6979
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 20639 Kentucky
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X C148038 California

Profile Details

NPI number 1104802594
LBN Legal business name Greene, David A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 19th, 2005
Last updated Jun 22nd, 2021 - about 3 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 1104802594 NPPES
Kentucky MEDICAID 64206394

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