Individual provider · Type 1 NPI

Henrietta Anne Green, PA-C

Medical Physician Assistant · Fontana, CA

NPI number 1548819634 Active

Practice location

17577 Arrow Blvd
Fontana, CA 92335-4011

Mailing address

660 N Idyllwild Ave
Rialto, CA 92376-4814

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XNone listed

Medical Physician Assistant: Definition to come...

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About NPI 1548819634

Henrietta Anne Green, PA-C's National Provider Identifier is 1548819634, issued on Sep 10, 2019. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Fontana, CA. The record was last updated on Sep 10, 2019.