| Green Flash Physician Oversight Pc | |
|
2868 Bayside Walk Unit C San Diego CA 92109-8119 | |
| (917) 273-4092 | |
| Not Available |
| Full Name | Green Flash Physician Oversight Pc |
|---|---|
| Speciality | Psychiatry & Neurology - Clinical Neurophysiology |
| Location | 2868 Bayside Walk Unit C, San Diego, California |
| Authorized Official Name and Position | Joseph John Moreira (PESIDENT) |
| Authorized Official Contact | 9172734092 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Green Flash Physician Oversight Pc 198 Sussex Dr Manhasset NY 11030-3737 Ph: (172) 734-0929 | Green Flash Physician Oversight Pc 2868 Bayside Walk Unit C San Diego CA 92109-8119 Ph: (917) 273-4092 |
| NPI Number | 1316560378 |
|---|---|
| Provider Enumeration Date | 05/26/2020 |
| Last Update Date | 05/29/2020 |
| Certification Date | 05/29/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316560378 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0600X | Psychiatry & Neurology - Clinical Neurophysiology | (* (Not Available)) | Primary |
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