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John Green
NPI 1932800851 · on the registry since 2023
Practice
- Address
- 4456 Manzanita Ave Ste 2
Clearlake, CA 95422 - Phone
- (802) 487-9421
- Clinicians at this address
- 12
Registry record
- Primary taxonomy
- 103K00000X
103K00000X
- Licence states on file
- NULL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2023-03-16
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California