Individual
DR. DAMON LAMONT GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9961 SIERRA AVE, FONTANA, CA 92335-6720
(909) 427-5330
Mailing address
9961 SIERRA AVE, FONTANA, CA 92335-6720
(888) 750-0036
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A82704
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A827040
MEDI-CAL
CA
Enumeration date
10/19/2006
Last updated
11/30/2021
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