Individual
DR. JODY M GREENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
27262 ESGOS, MISSION VIEJO, CA 92692-3301
(949) 624-1117
Mailing address
PO BOX 4557, MISSION VIEJO, CA 92690
(949) 624-1117
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E3149
CA
213EP1101X
Primary Podiatric Medicine Podiatrist
E3149
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E31490
—
CA
01
—
126213600
DEPT OF LABOR US
CA
01
—
480027973
RAILROAD MEDICARE
CA
Enumeration date
08/22/2006
Last updated
04/20/2023
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