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General NPI Number Information
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NPI Number | 1700072899
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Entity Type | Individual
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Provider Name | WILLIAM J. GREENE D.C,,QME
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Gender | Male
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Dates
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Enumeration Date | 09/21/2007
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Last Update Date | 09/21/2007
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Provider Practice Location Address
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Address Line | 330 N BREA BLVD SUITE K
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City | BREA
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State | CA
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Zip | 92821-4054
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Country | US
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Telephone | 562-777-5552
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Fax | 714-671-2156
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Provider Business Mailing Address
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Address Line | 839 COCAO PL
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City | BREA
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State | CA
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Zip | 92821-3633
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Country | US
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Telephone | 562-777-5552
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Fax | 714-671-2156
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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 | 111NI0013X
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Taxonomy Name | Independent Medical Examiner Chiropractor
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License Number | DC22353
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License Number State | CA
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