Individual
JEFFREY PAUL GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4150 V ST, PSSB 2100, SACRAMENTO, CA 95817-1460
(646) 942-8290
(916) 762-9040
Mailing address
4150 V ST, PSSB 2100, SACRAMENTO, CA 95817-1460
(646) 942-8290
(916) 762-9040
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
228435
NY
207P00000X
Emergency Medicine Physician
Primary
C54103
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02443341
—
NY
Enumeration date
07/24/2006
Last updated
12/15/2021
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