Green Dermatologic Medical Group a Medical Corporation
NPI #1154533685 in San Clemente, California
Provider Information
- NPI Number
- 1154533685
- Entity Type
- Organization
- Organization Name
- Green Dermatologic Medical Group a Medical Corporation
- Primary Specialty
- Specialist
- Enumeration Date
- May 4, 2007
- Last Updated
- May 4, 2018
Practice Location
- Address
- 657 CAMINO DE LOS MARES STE 242
- City
- San Clemente
- State
- California
- ZIP Code
- 92673-2811
- Phone
- (949) 496-6066
Authorized Official
- Name
- DR. ROGER E GREEN, M. D.
- Title
- MEDICAL DOCTOR
- Phone
- (949) 496-6066
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist |
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