MEDICARE: DR. DEBORAH REYNOLDS GREENE M.D.

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	2083P0901X	Public Health & General Preventive Medicine Physician	A56446	CA

General Provider Information

NPI Number	:	1437379559
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEBORAH REYNOLDS GREENE M.D.

Provider Business Mailing Address
First Line	:	10850 MACARTHUR BLVD
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94605-5266
Country	:	US
Telephone Number	:	510-569-9334
Fax Number	:	510-569-9309

Provider Business Practice Location Address
First Line	:	10850 MACARTHUR BLVD
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94605-5266
Country	:	US
Telephone Number	:	510-569-9334
Fax Number	:	510-569-9309

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

Provider Enumeration Date	:	04/30/2007
Last Update Date	:	05/22/2009

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