# GREEN SPORTS MEDICINE INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Green Sports Medicine, Inc.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396210563
- **Authorized official:** ERICK GREEN MD (MD)
- **Authorized official phone:** (559) 813-3005

## Contact information

- **Practice address:** 2021 HERNDON AVE STE 201, CLOVIS, CA 93611-6101
- **Practice address phone:** (559) 981-5566
- **Practice address fax:** (559) 228-9989
- **Mailing address:** 7471 N FRESNO ST, FRESNO, CA 93720-2457
- **Mailing address phone:** (559) 981-5566
- **Mailing address fax:** (559) 228-9989

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | — | NULL | Yes |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | — | — | Yes |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | — | NULL | — |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | — | — | — |

## Other

- **Enumeration date:** 10/03/2018
- **Last updated:** 09/23/2026