Healthcare Provider Details

I. General information

NPI: 1467587907
Provider Name (Legal Business Name): CHRISTINA BERRY GREEN OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2007
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: 310-722-6113
  • Fax:
Mailing address:
  • Phone: 310-722-6113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberCO1556
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: