Individual
JORDAN HOWARD GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1100 MARSHALL WAY, PLACERVILLE, CA 95667-6599
(530) 622-1441
Mailing address
1100 MARSHALL WAY, PLACERVILLE, CA 95667-6599
(530) 622-1441
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
A195801
CA
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
A195801
CA
Other
Enumeration date
06/06/2018
Last updated
12/12/2024
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