MEDICARE: LINDA ANNAN GREENE DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	22740	MA

General Provider Information

NPI Number	:	1093257818
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA ANNAN GREENE DPT

Provider Business Mailing Address
First Line	:	10505 SORRENTO VALLEY RD STE 200
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-1619
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10505 SORRENTO VALLEY RD
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-1618
Country	:	US
Telephone Number	:	858-793-7860
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2016
Last Update Date	:	01/13/2025

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Directions to “ LINDA ANNAN GREENE DPT” Practice Location

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