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Individual

CLARE A GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
510 SUPERIOR AVE, STE 200B, NEWPORT BEACH, CA 92663-3663
(949) 791-3001
(949) 791-3096
Mailing address
510 SUPERIOR AVE, STE 200B, NEWPORT BEACH, CA 92663-3663
(949) 791-3001
(949) 791-3096

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20A11841
CA
207Q00000X
Family Medicine Physician
DO23355
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
286263
OR
Enumeration date
08/17/2006
Last updated
06/12/2013
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