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Organization

LYDIA GREEN MD INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LYDIA GREEN MD (OWNER)
(323) 691-1772
Entity
Organization

Contact information

Practice address
1600 W AVENUE J, LANCASTER, CA 93534-2814
(323) 691-1772
Mailing address
2851 W 120TH ST STE E-134, HAWTHORNE, CA 90250-3395
(323) 691-1772

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary

Other

Enumeration date
04/30/2019
Last updated
09/10/2019
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