Healthcare Provider Details

I. General information

NPI: 1295858512
Provider Name (Legal Business Name): WILLIAM SCOTT GREEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 02/05/2021
Certification Date: 02/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3838 CALIFORNIA ST SUITE 715
SAN FRANCISCO CA
94118-1522
US

IV. Provider business mailing address

3838 CALIFORNIA ST SUITE 715
SAN FRANCISCO CA
94118-1522
US

V. Phone/Fax

Practice location:
  • Phone: 415-668-8010
  • Fax: 415-752-2560
Mailing address:
  • Phone: 415-668-8010
  • Fax: 415-752-2560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberA95223
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberA95223
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: