Green Valley Laser, LLC

Organization Active NPI Customized Equipment (DME) · Freedom, CA

NPI 1669551271 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1669551271
Entity type
Organization (NPI type 2)
Primary specialty
Customized Equipment (DME) 332BC3200X
License
G75256 MED DIRECTOR (CA)
Legal business name
GREEN VALLEY LASER, LLC
Practice address
160 Green Valley Rd
Suite 201
Freedom, CA 95019-3160
Phone
(831) 722-2445
Fax
(831) 722-6032
NPI assigned
Nov 3, 2006
Organization subpart
No

Authorized official

Name
Dr. David S. Benjamin, M.D.
Title
Director
Phone
(831) 722-2445

National Provider Directory

Locations

160 Green Valley Rd
Ste 201
Freedom, CA 95019
Phone (831) 724-7874

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X G75256 MED DIRECTOR CA Yes

Addresses

Primary practice location

160 Green Valley Rd
Suite 201
Freedom, CA 95019-3160

Mailing address

160 Green Valley Rd
Suite 201
Freedom, CA 95019-3160
Phone (831) 722-2445

Other providers in Freedom, CA

All providers in Freedom, CA · Customized Equipment (DME) in California

Sources for this page

Verify at the official NPI Registry.