Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | G87639 | CA |
NPI | 1326131541 |
---|---|
Provider Name | Christopher O'reilly-Green |
First Address | Modesto, CA 95350 |
Second Address | Modesto, CA 95350 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 08/11/2016 |