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NPI Code Detail

MEDICARE: CHANNING GREENBURG D.O.

MEDICARE: CHANNING GREENBURG D.O.
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
1208000000XPediatrics Physician20A21949CA
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1134858038
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHANNING GREENBURG D.O.
Provider Business Mailing Address
First Line : 1201 W LA VETA AVE
Second Line :
City : ORANGE
State : CA
Zip : 92868-4203
Country : US
Telephone Number : 714-203-2181
Fax Number :
Provider Business Practice Location Address
First Line : 1201 W LA VETA AVE
Second Line :
City : ORANGE
State : CA
Zip : 92868-4203
Country : US
Telephone Number : 714-203-2181
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2022
Last Update Date : 01/15/2026

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Directions to “ CHANNING GREENBURG D.O.” Practice Location

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