Bradley Alan Greene, MD

Primary specialty

Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X

License

A74002 Issued in CA

Practice address

3130 Alpine Rd
Suite 195
Portola Valley, CA 94028-7549

Phone

(650) 851-0155

Fax

(650) 529-0929

NPI assigned

Sep 26, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373241600000",
    "number": "1811098379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3130 ALPINE RD",
            "address_2": "SUITE 195",
            "city": "PORTOLA VALLEY",
            "state": "CA",
            "postal_code": "940287549",
            "telephone_number": "650-851-0155",
            "fax_number": "650-529-0929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 ALPINE RD",
            "address_2": "SUITE 195",
            "city": "PORTOLA VALLEY",
            "state": "CA",
            "postal_code": "940287549",
            "telephone_number": "650-851-0155",
            "fax_number": "650-529-0929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "BRADLEY",
        "middle_name": "ALAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2013-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "CA",
            "license": "A74002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mackenzie Lauren Froeberg, MA
• Andrew Hok-Cay Fung, DPT
• Gazebo Medical Corporation, P.C.
• Lisa Diane Green, MOMT, MPT, ATC
• Bradley Greenblott, M.D.
• Kathryn Joanne Hallsten, M.D.
• Adam Christopher Hardy
• Healthtap Medical Group, P.C.
• Healthtap Medical Group, P.C.
• Healthtap Medical Group, PC

• Facial Plastic Surgery Physician in Portola Valley, CA
• Providers in Portola Valley, CA by specialty
• Facial Plastic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2013; 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.