Individual
LYDIA MARIE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6033 W CENTURY BLVD STE 200, LOS ANGELES, CA 90045-6440
(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
207QA0505X
Adult Medicine Physician
Primary
A068297
CA
Other
Enumeration date
07/11/2006
Last updated
09/17/2018
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