Individual
NELLA GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
15644 POMERADO RD, SUITE 202, POWAY, CA 92064-2400
(858) 312-5459
(858) 345-3743
Mailing address
PO BOX 1770, LA MESA, CA 91944-1770
(858) 312-5459
(858) 345-3743
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A113685
CA
207RI0200X
Infectious Disease Physician
Primary
A113685
CA
Other
Enumeration date
05/05/2009
Last updated
02/23/2017
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