Green, Geoffrey Riley

Green, Geoffrey Riley is an individual health care provider with primary practice located at 1100 West Stewart Drive , Orange CA 92868-3849. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Green, Geoffrey Riley can be contacted via phone (714) 633-9111.

Contact Information

Primary practice address
1100 West Stewart Drive Orange CA 92868-3849
Phone: (714) 633-9111
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA17453 California

Profile Details

NPI number 1306878533
LBN Legal business name Green, Geoffrey Riley
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2006
Last updated Jan 13th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306878533 NPPES
California MEDICAID PA17453

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