John Greene

Individual provider Active NPI Driver · Rosamond, CA

NPI 1275908741 · NPPES record last updated Oct 16, 2018

Key facts

NPI
1275908741
Entity type
Individual (NPI type 1)
Primary specialty
Driver 172A00000X
License
N7116688 (CA)
Practice address
1111 Sierra Hwy
Rosamond, CA 93560
Phone
(661) 754-6622
Fax
(661) 256-7678
NPI assigned
Dec 9, 2015
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
N7116688CAMDDriver

Practice roles

OrganizationSpecialtyStatusNew patients
Av Medical Transportation Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X N7116688 CA Yes

Addresses

Primary practice location

1111 Sierra Hwy
Rosamond, CA 93560

Mailing address

PO Box 1205
Rosamond, CA 93560-1205
Phone (661) 754-6622

Other providers in Rosamond, CA

All providers in Rosamond, CA · Driver in California

Sources for this page

Verify at the official NPI Registry.