Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | G60795 | CA |
N | 111NI0900X | Internist | G60795 | CA |
N | 207RP1001X | Pulmonary Disease | G60795 | CA |
NPI | 1043390735 |
---|---|
Provider Name | Dr. Ronald Alan Greeno |
First Address | Los Angeles, CA 90017 |
Second Address | Los Angeles, CA 90017 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G607950 | (05) | CA |
C46707 | (02) |