Dr Jacob Irving Green, DPM | |
9474 Base Line Rd, Alta Loma, CA 91701-5822 | |
(909) 987-3211 | |
(909) 987-0317 |
Full Name | Dr Jacob Irving Green |
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Gender | Male |
Speciality | Podiatrist |
Location | 9474 Base Line Rd, Alta Loma, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1578188256 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213E00000X | Podiatrist | E5897 (California) | Primary |
213E00000X | Podiatrist | EL6961 (California) | Secondary |
Provider Name | Bruening Foot And Ankle Inc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1912145327 PECOS PAC ID: 6901079409 Enrollment ID: O20111028000097 |
Provider Name | Empire Foot And Ankle Center Inc. |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1205387461 PECOS PAC ID: 1254617244 Enrollment ID: O20170405001009 |
Mailing Address | Practice Location Address |
---|---|
Dr Jacob Irving Green, DPM 9474 Base Line Rd, Alta Loma, CA 91701-5822 Ph: (909) 987-3211 | Dr Jacob Irving Green, DPM 9474 Base Line Rd, Alta Loma, CA 91701-5822 Ph: (909) 987-3211 |
Dr. William Christopher Landrey, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 9474 Baseline Rd, Alta Loma, CA 91701 Phone: 909-987-3211 Fax: 909-987-0317 | |
Inland Podiatry Center Professional Corporation Podiatrist Medicare: Medicare Enrolled Practice Location: 9474 Baseline Rd, Alta Loma, CA 91701 Phone: 909-987-3211 Fax: 909-987-0317 | |
Bryan Katz, Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 5353 Woodridge Ct, Alta Loma, CA 91737 Phone: 909-702-3422 |