| Abe Green Md A Prof Medical Corp | |
|
2080 Century Park East Suite 1410 Los Angeles CA 90067 | |
| (310) 282-8202 | |
| (310) 553-9103 |
| Full Name | Abe Green Md A Prof Medical Corp |
|---|---|
| Speciality | Internal Medicine |
| Location | 2080 Century Park East, Los Angeles, California |
| Authorized Official Name and Position | Abe Green (PRESIDENT OWNER) |
| Authorized Official Contact | 3102828202 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Abe Green Md A Prof Medical Corp 2080 Century Park East Suite 1410 Los Angeles CA 90067 Ph: (310) 282-8202 | Abe Green Md A Prof Medical Corp 2080 Century Park East Suite 1410 Los Angeles CA 90067 Ph: (310) 282-8202 |
| NPI Number | 1033299250 |
|---|---|
| Provider Enumeration Date | 10/16/2006 |
| Last Update Date | 08/17/2007 |
| Medicare PECOS PAC ID | 9830382902 |
|---|---|
| Medicare Enrollment ID | O20101021000256 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033299250 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | G48234 (California) | Secondary |
| 207RN0300X | Internal Medicine - Nephrology | G48234 (California) | Primary |
| Provider Name | Abe Green |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649462144 PECOS PAC ID: 0749473817 Enrollment ID: I20101021000303 |
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