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NPI Code Detail

MEDICARE: DR. EDWARD WILLIAM GREENE

MEDICARE: DR. EDWARD WILLIAM GREENE
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
1207R00000XInternal Medicine PhysicianA82156CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1265401368
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EDWARD WILLIAM GREENE
Provider Business Mailing Address
First Line : 1400 E PALOMAR ST
Second Line :
City : CHULA VISTA
State : CA
Zip : 91913-1800
Country : US
Telephone Number : 858-499-2600
Fax Number : 619-397-3380
Provider Business Practice Location Address
First Line : 1400 E PALOMAR ST
Second Line :
City : CHULA VISTA
State : CA
Zip : 91913-1800
Country : US
Telephone Number : 858-499-2600
Fax Number : 619-397-3380
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2006
Last Update Date : 10/01/2014

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