Individual provider · Type 1 NPI
Charles Gary Green, MD
Body Imaging Physician · Susanville, CA
NPI number
1073698189
Active
Practice location
60 Hall Street
Susanville, CA 96130
Fax (530) 257-6038
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Body Imaging Physician Primary | 2085B0100X | G46958 (CA) |
Body Imaging Physician: A Radiology doctor of Osteopathy that specializes in Body Imaging.
About NPI 1073698189
Charles Gary Green, MD's National Provider Identifier is 1073698189, issued on Oct 26, 2006. The primary taxonomy on file is Body Imaging Physician (2085B0100X), and the practice location is in Susanville, CA. The record was last updated on Jul 8, 2007.