ROGER ELLIOTT GREEN (NPI# 1215917968) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215917968 |
| Entity Type | Individual |
| Full Name | ROGER ELLIOTT GREEN |
| Credential | MD |
| Practice Address |
657 Camino De Los Mares Suite 242 San Clemente CA 92673 |
| Mailing Address |
657 Camino De Los Mares Suite 242 San Clemente CA 92673-2826 |
| Practice Telephone | 9494966066 |
| Practice Fax Number | 9494966497 |
| Mailing Telephone | 9494966066 |
| Mailing Fax Number | 9494966497 |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2009-11-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | C36384 | CA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639200157 | Roger Alan Green | Dentist | 13920 W Camino Del Sol Ste 9, Sun City West, AZ 85375-4438 | 2007-03-08 |
| 1295764892 | Roger A. Green | Nurse Practitioner | 6630 S Mccarran Blvd Ste A12, Reno, NV 89509-6114 | 2006-07-03 |
| 1376591321 | Roger D Green | Specialist | 550 Route 299, Suite 200, Highland, NY 12528-2875 | 2006-05-04 |
| 1275537912 | Roger Leroy Green | Family Medicine | 1200 Mclain St, Newport, AR 72112-3534 | 2005-06-10 |
| Street Address |
657 CAMINO DE LOS MARES SUITE 242 |
| City | SAN CLEMENTE |
| State | CA |
| Zip Code | 92673 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427058395 | Ronald Stanley Saltzman | Internal Medicine | 657 Camino De Los Mares, #135, San Clemente, CA 92673-2826 | 2005-07-21 |
| 1689026346 | Catherine Janet Girard | Marriage & Family Therapist | 657 Camino De Los Mares, Suite 241, San Clemente, CA 92673-2826 | 2016-07-06 |
| 1447642152 | Obaidi Dental Corporation | Dentist | 657 Camino De Los Mares, Suite 138, San Clemente, CA 92673-2826 | 2015-03-04 |
| 1679917736 | Kelly Burris | Counselor | 657 Camino De Los Mares, 241, San Clemente, CA 92673 | 2013-04-19 |
| 1598007262 | Paul Reischl | Dentist | 657 Camino De Los Mares, Ste 245, San Clemente, CA 92673-2826 | 2013-03-20 |
| 1235370966 | Aravinda Kumar Shetty | Dentist | 657 Camino De Los Mares, Suite 137, San Clemente, CA 92673-2826 | 2009-03-09 |
| 1255583126 | Anmar Obaidi | Dentist | 657 Camino De Los Mares, Suite 138, San Clemente, CA 92673-2826 | 2008-10-22 |
| 1225298573 | Nirav Patel M D A Professional Corporation | Family Medicine | 657 Camino De Los Mares, Suite 241, San Clemente, CA 92673-2811 | 2008-06-11 |
| 1154506079 | Andrew Allan Young | Dentist | 657 Camino De Los Mares, Suite 132, San Clemente, CA 92673-2826 | 2008-01-09 |
| 1538282520 | Peter M. Rothenberg, M.d.,inc. | Internal Medicine | 657 Camino De Los Mares, Suite 137, San Clemente, CA 92673-2826 | 2007-04-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497246474 | Cynthia Hull Warren | Nutritionist | 2027 Via Concha, San Clemente, CA 92673 | 2018-05-24 |
| 1063942688 | Trinh T Tran | Pharmacist | 638 Camino De Los Mares #d5, San Clemente, CA 92673 | 2017-06-15 |
| 1427421791 | Jessica A Currens | Nurse Practitioner | 1001 Avenida Pico Ste C517, San Clemente, CA 92673 | 2015-11-08 |
| 1184010647 | Garrett Bryon Rubio | Student in an Organized Health Care Education/Training Program | 905 Calle Amanecer Ste. 265, San Clemente, CA 92673 | 2015-04-11 |
| 1255733853 | Body Mind Spirit Iop Inc | Psychologist | 665 Camino De Los Mares Ste 104, San Clemente, CA 92673 | 2014-09-25 |
| 1548677438 | Jessica Ann Riley | Dermatology | 1300 Avenida Vista Hermosa Ste 150, San Clemente, CA 92673 | 2014-07-13 |
| 1427398718 | Veena Menda | Specialist | 2232 Calle Opalo, San Clemente, CA 92673 | 2013-02-22 |
| 1124383781 | Alexandra Rose Corporation | Substance Abuse Rehabilitation Facility | 4009 Calle Abril, San Clemente, CA 92673 | 2012-07-10 |
| 1457612574 | Noelle J Deckman | Psychologist | 629 Camino De Los Mares Ste 207a, San Clemente, CA 92673 | 2012-06-05 |
| 1851686471 | Meighan Bartholomew Merono | Pharmacist | 990 Avenida Vista Hermosa, San Clemente, CA 92673 | 2011-06-10 |
| Find all providers in zip 92673 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548677438 | Jessica Ann Riley | Dermatology | 1300 Avenida Vista Hermosa Ste 150, San Clemente, CA 92673 | 2014-07-13 |
| 1336279728 | Richard P Klimkowski | Dermatology | 224 Del Mar #b, San Clemente, CA 92672 | 2007-03-06 |
| 1306982855 | La Laser Center, PC, A Professional Medical Corporation | Dermatology | 161 Avenida Vaquero, San Clemente, CA 92672-3601 | 2007-01-30 |
| 1962556548 | Nagi Kamil Saied | Dermatology | 653 Camino De Los Mares, Suite 107, San Clemente, CA 92673-2808 | 2007-01-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275144024 | Lumins Aesthetic and Wellness, Inc | Dermatology | 20281 Sw Birch St, Suite 201, Newport Beach, CA 92660 | 2020-08-14 |
| 1669081204 | Lucy Boyadzhian | Dermatology | 7472 Melrose Ave, Los Angeles, CA 90046-7524 | 2020-07-29 |
| 1033730981 | Adrianna Janell Browne, Md, Inc. | Dermatology | 8 Camino Encinas Ste 115, Orinda, CA 94563-3350 | 2020-05-01 |
| 1215564877 | Jasmine Khachatrian | Dermatology | 302 Sierra Woods Dr, Sierra Madre, CA 91024-1015 | 2020-03-24 |
| 1386277499 | Jessica Hsu, M.d.,inc | Dermatology | 1506 Chapman Avenue, Address Line 2, Orange, CA 92866 | 2020-02-17 |
| 1245862101 | Yuval Bibi, A Professional Corporation | Dermatology | 7266 Franklin Ave Apt 321, Los Angeles, CA 90046-8324 | 2020-02-09 |
| 1457982001 | Modesty Joy Isaguirre | Dermatology | 140 S Grand Ave, Glendora, CA 91741-4259 | 2020-02-03 |
| 1790322063 | Mfc Dermatology | Dermatology | 3655 Lomita Blvd Ste 221, Torrance, CA 90505-1918 | 2019-12-05 |
| 1336784206 | Barbara Kinkle Pa Inc., A Physician Assistant Corporation | Dermatology | 24575 Hunt Ave, Corning, CA 96021-8607 | 2019-11-14 |
| 1497399141 | Dermatology Specialists Inc | Dermatology | 4765 Carmel Mountain Rd Ste 201, San Diego, CA 92130-6657 | 2019-11-05 |
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| City | SAN CLEMENTE |
| Zip Code | 92673 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.