Individual
DONALD ROBERT GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
770 WASHINGTON ST, SUITE 202, SAN DIEGO, CA 92103-2209
(619) 291-0777
(619) 291-3231
Mailing address
770 WASHINGTON ST, SUITE 202, SAN DIEGO, CA 92103-2209
(619) 291-0777
(619) 291-3231
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E1503
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OOOE15030
BLUE SHIELD
CA
Enumeration date
05/31/2006
Last updated
07/08/2007
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