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General NPI Number Information
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NPI Number | 1699638114
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Entity Type | Individual
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Provider Name | CHARON GREEN
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Gender | Female
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Dates
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Enumeration Date | 12/03/2025
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 835 STANFORD AVE
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City | LOS ANGELES
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State | CA
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Zip | 90021-1847
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Country | US
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Telephone | 213-896-2640
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Fax |
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Provider Business Mailing Address
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Address Line | 5000 HOLLYWOOD BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90027-6104
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Country | US
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Telephone | 213-250-4800
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number | B67A365E5B
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License Number State | CA
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