Charles Gary Green, MD is a
Radiology - Body Imaging physician based in Susanville, California. Charles Gary Green is licensed to practice in California (license number G46958) and his current practice location is 60 Hall Street, Susanville, California. He can be reached at his office (for appointments etc.) via phone at
(530) 257-6010.
NPI number for Charles Gary Green is 1073698189 and his current mailing address is 60 Hall Street, Susanville, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1073698189.
Physician's Profile
| Full Name | Charles Gary Green |
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| Gender | Male |
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| Speciality | Radiology - Body Imaging |
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| Location | 60 Hall Street, Susanville, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1073698189
- Provider Enumeration Date: 10/26/2006
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Charles Gary Green such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1073698189 | NPI | - | NPPES |
| 00G469582 | Medicaid | CA | |
| 5424723 | Other | | MEDICAL PIN |
| 00G469580 | Other | | BLUE CROSS |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 2085B0100X | Radiology - Body Imaging | G46958 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Charles Gary Green is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Charles Gary Green, MD
60 Hall Street,
Susanville, CA 96130
Ph: (530) 257-6010 | Charles Gary Green, MD
60 Hall Street,
Susanville, CA 96130
Ph: (530) 257-6010 |
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