Individual provider Active NPI

Sean Gaston Green, PHARM.D.

  • Pediatric Pharmacist
  • Palo Alto, CA
National Provider Identifier
1265977177
Registry record updated Jan 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric PharmacistTaxonomy code 1835P0200X
License
69852 Issued in CA
Practice address
725 Welch Rd
MC 5901
Palo Alto, CA 94304-1601
Phone
(650) 498-7288
NPI assigned
Jan 1, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 1, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Pharmacist 1835P0200X PH236329 MA
Pediatric Pharmacist 1835P0200X 69852 CA Primary

Addresses

Primary practice location

725 Welch Rd
MC 5901
Palo Alto, CA 94304-1601

Mailing address

725 Welch Rd
MC 5901
Palo Alto, CA 94304-1601
Phone (650) 498-7288

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
69852CAMDPediatric Pharmacist
PH236329MAMDPediatric Pharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1483228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483228800000",
    "number": "1265977177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 WELCH RD",
            "address_2": "MC 5901",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041601",
            "telephone_number": "650-498-7288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 WELCH RD",
            "address_2": "MC 5901",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041601",
            "telephone_number": "650-498-7288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "SEAN",
        "middle_name": "GASTON",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-01",
        "last_updated": "2017-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pediatrics",
            "state": "MA",
            "license": "PH236329",
            "primary": false
        },
        {
            "code": "1835P0200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pediatrics",
            "state": "CA",
            "license": "69852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.