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General NPI Number Information
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NPI Number | 1740308998
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Entity Type | Organization
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Legal Business Name | DAVID L. GREENE, M.D. INC.
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 04/08/2009
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Provider Practice Location Address
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Address Line | 153 PIONEER LN STE C
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City | BISHOP
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State | CA
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Zip | 93514-2517
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Country | US
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Telephone | 760-873-8982
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Fax | 760-873-3198
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Provider Business Mailing Address
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Address Line | 153 PIONEER LN STE C
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City | BISHOP
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State | CA
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Zip | 93514-2517
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Country | US
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Telephone | 760-873-8982
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Fax | 760-873-3198
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID L GREENE
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Credential | M.D.
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Telephone | 760-873-8982
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | C402070
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License Number State | CA
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