Individual
DANIEL JAMES GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1667 DOMINICAN WAY STE 234, SANTA CRUZ, CA 95065-1560
(831) 533-0911
(813) 464-8603
Mailing address
3400 DATA DR, ATTN CREDENTIALING/PAYER ENROLLMENT, RANCHO CORDOVA, CA 95670-7956
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
A154075
CA
Other
Enumeration date
03/08/2012
Last updated
03/09/2020
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