| Green Medical Group | |
|
995 W Foothill Blvd Claremont CA 91711-3304 | |
| (714) 655-8298 | |
| (808) 855-3055 |
| Full Name | Green Medical Group |
|---|---|
| Speciality | General Practice |
| Location | 995 W Foothill Blvd, Claremont, California |
| Authorized Official Name and Position | Diem Le (CORPORATE SECRETARY) |
| Authorized Official Contact | 7146558298 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Green Medical Group 995 W Foothill Blvd Claremont CA 91711-3304 Ph: (714) 655-8298 | Green Medical Group 995 W Foothill Blvd Claremont CA 91711-3304 Ph: (714) 655-8298 |
| NPI Number | 1225918014 |
|---|---|
| Provider Enumeration Date | 09/03/2025 |
| Last Update Date | 09/03/2025 |
| Certification Date | 09/03/2025 |
| Medicare PECOS PAC ID | 0042701104 |
|---|---|
| Medicare Enrollment ID | O20251117002073 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225918014 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | () | Primary |
| Provider Name | Khanh Ngoc Tuan Duong |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1295754125 PECOS PAC ID: 8527959436 Enrollment ID: I20040322000912 |
| Provider Name | Mohitkumar Ardeshana |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467867135 PECOS PAC ID: 6901176742 Enrollment ID: I20170726003510 |
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