Organization Active NPI

Joseph H Greenberg LTD a Medical Corp

  • Specialist
  • San Rafael, CA
National Provider Identifier
1780857318
Registry record updated Jul 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
C35289 Issued in CA
Legal business name
JOSEPH H GREENBERG LTD A MEDICAL CORP
Practice address
750 Las Gallinas Ave
Suite 205
San Rafael, CA 94903-3438
Phone
(415) 472-3903
Fax
(415) 472-2102
NPI assigned
Apr 3, 2008
Last updated
Jul 27, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2010

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

Authorized official

Name
Dr. Joseph H Greenberg, M.D.NPI 1912085937
Title
Dermatologist
Phone
(415) 472-3903

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X C35289 CA Primary

Addresses

Primary practice location

750 Las Gallinas Ave
Suite 205
San Rafael, CA 94903-3438

Mailing address

750 Las Gallinas Ave
Suite 205
San Rafael, CA 94903-3438
Phone (415) 472-3903

Other identifiers 1

IdentifierTypeStateIssuer
C352890MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101005000801 CA Part B Supplier - Clinic/Group Practice 3678765971 Receives reassigned benefits from 5 practitioners
Practice locations: San Rafael, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1207180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280188800000",
    "number": "1780857318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 LAS GALLINAS AVE",
            "address_2": "SUITE 205",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949033438",
            "telephone_number": "415-472-3903",
            "fax_number": "415-472-2102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 LAS GALLINAS AVE",
            "address_2": "SUITE 205",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949033438",
            "telephone_number": "415-472-3903",
            "fax_number": "415-472-2102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH H GREENBERG LTD A MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-03",
        "last_updated": "2010-07-27",
        "status": "A",
        "authorized_official_last_name": "GREENBERG",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "DERMATOLOGIST",
        "authorized_official_telephone_number": "415-472-3903",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "C35289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "C352890",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.