# GREEN SPORTS MEDICINE INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366354029
- **Authorized official:** SONYA LEAL (ADMIN)
- **Authorized official phone:** (559) 387-5230

## Contact information

- **Practice address:** 7471 N FRESNO ST, FRESNO, CA 93720-2457
- **Practice address phone:** (559) 813-3005
- **Mailing address:** 2021 HERNDON AVE STE 201, CLOVIS, CA 93611-6317
- **Mailing address phone:** (559) 387-5230

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | — | NULL | Yes |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | — | — | Yes |
| 207XS0117X | Orthopaedic Surgery of the Spine Physician | — | NULL | — |
| 207XS0117X | Orthopaedic Surgery of the Spine Physician | — | — | — |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | — | NULL | — |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | — | — | — |

## Other

- **Enumeration date:** 09/18/2026
- **Last updated:** 09/18/2026