person
Charles Gary Green, MD
Body Imaging Physician in Susanville, California
NPI 1073698189

Charles Gary Green is a Body Imaging Physician based in Susanville, CA and is specialized in Body Imaging. Charles Gary Green practices in Susanville, CA and has the professional credentials of MD. The NPI Number for Charles Gary Green is 1073698189 and holds a License No. G46958 (California).

The current practice location address for Charles Gary Green is 60 Hall Street, Susanville, CA and can be reached out via phone at 530-257-6010 and via fax at 530-257-6038.

Location: 60 Hall Street, Susanville, CA, 96130
person
Provider Profile Details
NPI Number
1073698189
Provider Name
Charles Gary Green
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
60 Hall Street, Susanville, CA, 96130
Phone Number
530-257-6010
Fax Number
530-257-6038
Provider Enumeration Date
10/26/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00G469582 05 CA
5424723 01 MEDICAL PIN
00G469580 01 BLUE CROSS
institution
Provider Business Practice Location Address Details
Address
60 Hall Street
City
State
Zip
96130
Phone Number
530-257-6010
Fax Number
530-257-6038
person
Provider Business Mailing Address Details
Address
60 Hall Street
City
State
Zip
96130
Phone Number
530-257-6010
Fax Number
530-257-6038
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Body Imaging
Taxonomy
License No.
G46958 (California)
Definition
A Radiology doctor of Osteopathy that specializes in Body Imaging.
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