Individual
ANDREA L. GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10908 VANALDEN AVE, NORTHRIDGE, CA 91326-2646
(818) 360-5748
Mailing address
10908 VANALDEN AVE, NORTHRIDGE, CA 91326-2646
(818) 360-5748
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
G57355
CA
207R00000X
Internal Medicine Physician
G57355
CA
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
G57355
CA
207RP1001X
Pulmonary Disease Physician
17171
NV
207RP1001X
Pulmonary Disease Physician
G57355
CA
207RP1001X
Pulmonary Disease Physician
Primary
MD156568
OR
Other
Enumeration date
11/29/2006
Last updated
10/13/2021
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