Individual provider · Type 1 NPI

Justin Taylor Green

Student in an Organized Health Care Education/Training Program · Long Beach, CA

NPI number 1093312142 Active

Practice location

1760 Termino Ave Ste 208
Long Beach, CA 90804-2151

Call (562) 961-5655 Map

Fax (562) 961-8819

Mailing address

1052 Airshire Ln
Pomona, CA 91766-5559

Specialties and licenses

TaxonomyCodeLicense
Surgical Assistant 246ZC0007XNone listed
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1093312142

Justin Taylor Green's National Provider Identifier is 1093312142, issued on Oct 1, 2020. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Long Beach, CA. The record was last updated on Oct 1, 2020.