Green, Travis

Green, Travis is an individual health care provider with primary practice located at 26671 Aliso Creek Rd , Aliso Viejo CA 92656-4809. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is his primary health care specialty. Green, Travis can be contacted via phone (949) 791-3107.

Contact Information

Primary practice address
26671 Aliso Creek Rd Aliso Viejo CA 92656-4809
Phone: (949) 791-3107
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA60489241 Washington
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 8818001-1206 Utah
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA54390 California

Profile Details

NPI number 1750710919
LBN Legal business name Green, Travis
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 7th, 2013
Last updated Mar 18th, 2025 - about last year

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 1750710919 NPPES
Washington Other G8931677 MEDICARE PTAN
Washington MEDICAID 1750710919 MEDICARE PTAN

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