# ED GREEN CHIROPRACTIC, A PROFESSIONAL CORPORATION

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

## Provider details

- **NPI number:** 1649537721
- **Authorized official:** DR. EDWARD GREEN D.C, C.C.S.P (CHIROPRACTOR/PRESIDENT)
- **Authorized official phone:** (805) 531-1188

## Contact information

- **Practice address:** 301 SCIENCE DR, \#100, MOORPARK, CA 93021-2094
- **Practice address phone:** (805) 531-1188
- **Practice address fax:** (805) 531-1112
- **Mailing address:** 301 SCIENCE DR, \#100, MOORPARK, CA 93021-2094
- **Mailing address phone:** (805) 531-1188
- **Mailing address fax:** (805) 531-1112

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 29791 | CA | Yes |

## Other

- **Enumeration date:** 04/13/2012
- **Last updated:** 06/15/2012