| William J Greene Md Inc A Professional Medical Corporation | |
|
1501 Claus Rd Modesto CA 95355-9711 | |
| (209) 557-6310 | |
| Not Available |
| Full Name | William J Greene Md Inc A Professional Medical Corporation |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1501 Claus Rd, Modesto, California |
| Authorized Official Name and Position | William Greene (MD / OWNER) |
| Authorized Official Contact | 8043872117 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| William J Greene Md Inc A Professional Medical Corporation 220 Standiford Ave Ste F Modesto CA 95350-1159 Ph: (209) 579-5628 | William J Greene Md Inc A Professional Medical Corporation 1501 Claus Rd Modesto CA 95355-9711 Ph: (209) 557-6310 |
| NPI Number | 1932666112 |
|---|---|
| Provider Enumeration Date | 02/25/2019 |
| Last Update Date | 02/25/2019 |
| Medicare PECOS PAC ID | 8628406394 |
|---|---|
| Medicare Enrollment ID | O20200311000277 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932666112 | NPI | - | NPPES |
| 1396189791 | Other | CA | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | William James Greene |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396189791 PECOS PAC ID: 5092004788 Enrollment ID: I20171218002861 |
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