Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 38289 | CA |
N | 1223G0001X | General Practice | 38289 | CA |
N | 213EG0000X | General Practice | 38289 | CA |
NPI | 1215199195 |
---|---|
Provider Name | Dr. Veronica Greene |
First Address | Los Angeles, CA 90089-0058 |
Second Address | Los Angeles, CA 90089-0058 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2008 |
Last Update Date | 01/07/2008 |