Organization Active NPI

W Michael Green, MD Inc

  • Anatomic Pathology & Clinical Pathology Physician
  • Oxnard, CA
National Provider Identifier
1376601393
Registry record updated Jun 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
W MICHAEL GREEN, MD INC
Practice address
1600 N Rose Ave
Oxnard, CA 93030-3722
Phone
(805) 988-2644
NPI assigned
Dec 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2008

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

Authorized official

Name
WM Michael Green, MD
Title
President
Phone
(805) 988-2644

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X Primary

Addresses

Primary practice location

1600 N Rose Ave
Oxnard, CA 93030-3722

Mailing address

PO Box 25420
Ventura, CA 93002-2277
Phone (805) 650-5910

Other identifiers 2

IdentifierTypeStateIssuer
ZZZ42071ZOtherCABLUE SHIELD
GR0059650MedicaidCA

Other names 1

  • Wm Michael Green MD Inc. Other name

National Provider Directory

National Provider Directory

Locations

1600 N Rose Ave
#M
Oxnard, CA 93030
Phone (805) 504-6905

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1376601393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25420",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930022277",
            "telephone_number": "805-650-5910",
            "fax_number": "805-650-5972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 N ROSE AVE",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930303722",
            "telephone_number": "805-988-2644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W MICHAEL GREEN, MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "WM",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-988-2644",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ42071Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0059650",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wm Michael Green MD Inc.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Oxnard, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; 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.