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Individual

DOUGLAS WILLIAM GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
121 SOTOYOME ST, SANTA ROSA, CA 95405-4823
(707) 549-3141
(707) 546-7351
Mailing address
121 SOTOYOME ST, SANTA ROSA, CA 95405-4823
(707) 549-3141
(707) 546-7351

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A90305
CA
2086S0129X
Vascular Surgery Physician
A90305
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A903050
CA
Enumeration date
10/03/2006
Last updated
12/15/2021
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