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NPI Code Detail

MEDICARE: DR. JON ALLEN GREEN MD

MEDICARE: DR. JON ALLEN GREEN MD
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
1207RI0200XInfectious Disease PhysicianG67835CA

General Provider Information

NPI Number : 1609855345
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JON ALLEN GREEN MD
Provider Business Mailing Address
First Line : 150 MUIR RD
Second Line :
City : MARTINEZ
State : CA
Zip : 94553-4668
Country : US
Telephone Number : 925-372-2072
Fax Number : 925-372-2185
Provider Business Practice Location Address
First Line : 150 MUIR RD
Second Line :
City : MARTINEZ
State : CA
Zip : 94553-4668
Country : US
Telephone Number : 925-372-2072
Fax Number : 925-372-2185
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2006
Last Update Date : 06/21/2026

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