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Contact Information

ROGER E GREEN, MD
657 CAMINO DE LOS MARES
SUITE 242
SAN CLEMENTE, CA92673
 Phone: 949-496-6066
 Fax: 949-496-6497
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dermatology

207N00000X 07 Physician/Dermatology
Indicates primary specialty

NPI Profile & details for ROGER E GREEN · (Male)

NPI Number 1215917968
Status Active
Credentials MD
Entity Individual
Enumeration date 01/19/2006
Last updated 11/18/2009 - About 17 years ago
Sole proprietor 1 Yes
Identifiers
  • CA License # C36384
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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