Healthcare Provider Details

I. General information

NPI: 1205757309
Provider Name (Legal Business Name): CHRISTINA GREEN, OD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2031 S FEDERAL BLVD
DENVER CO
80219-5429
US

IV. Provider business mailing address

2031 S FEDERAL BLVD
DENVER CO
80219-5429
US

V. Phone/Fax

Practice location:
  • Phone: 720-807-7600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINA GREEN
Title or Position: PRESIDENT
Credential: OD
Phone: 310-722-6113