Individual
GOPA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2301 CIRCADIAN WAY, SUITE A, SANTA ROSA, CA 95407-5416
(707) 526-2027
(707) 526-2096
Mailing address
2301 CIRCADIAN WAY, SUITE A, SANTA ROSA, CA 95407-5416
(707) 526-2027
(707) 526-2096
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A91188
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A911880
—
CA
Enumeration date
05/13/2006
Last updated
05/02/2008
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