Individual
WILLIAM JAMES GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
ONE HOAG DR, ECU DEPT., NEWPORT BEACH, CA 92658-6100
(949) 764-5689
(405) 749-4561
Mailing address
PO BOX 720300, OKLAHOMA CITY, OK 73172-0300
(800) 749-4560
(405) 749-4561
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
G70480
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G704800
BLUE SHIELD
CA
05
—
00G704800
—
CA
05
—
00G704800670
—
CA
01
—
P00242841
RR MEDICARE
CA
Enumeration date
04/11/2006
Last updated
08/23/2010
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