| NPI Details | |
|---|---|
| NPI | 1073698189 |
| Gender | Male |
| Enumeration Date | 10/26/2006 |
| Last Updated | 07/08/2007 |
| Entity Type | Individual |
| Active | Over 11 years ago |
| Practice Location | |
|---|---|
| 60 HALL STREET SUSANVILLE CA, 96130, US |
|
| Phone | (530) 257-6010 |
| Fax | (530) 257-6038 |
| Business Location | |
|---|---|
| 60 HALL STREET SUSANVILLE CA, 96130, US |
|
| Phone | (530) 257-6010 |
| Fax | (530) 257-6038 |
| Toxanomy | |
|---|---|
| Taxonomy Code | 2085B0100X |
| License State | California |
| License Number | G46958 |
| Remove 1073698189 NPI Number | |
According to our database, Charles Gary Green MD NPI is 1073698189, taxonomy code is 2085B0100X and license number is G46958, license state is located at California. Charles Gary Green MD physically located at 60 Hall Street, Susanville CA, 96130. NPI Number Charles Gary Green MD has the Individual type.
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1073698189 NPI number is provided on an as is basis without warranty of any kind. 1073698189 is maintained by the National Plan & Provider Enumeration System. The contents of Charles Gary Green MD are for informational purposes only.
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