RICHARD GREEN, JR. (NPI# 1649624040) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649624040 |
| Entity Type | Individual |
| Full Name | RICHARD GREEN, JR. |
| Credential | PA-C |
| Practice Address |
2139 E Beechwood Ave Fresno CA 93720-0340 |
| Practice Telephone | 5593226600 |
| Practice Fax Number | 5593224625 |
| Mailing Telephone | 5593226600 |
| Mailing Fax Number | 5593224625 |
| Enumeration Date | 2016-04-21 |
| Last Update Date | 2020-09-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
53321 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 720 W Main St Ste A, Visalia, CA 932916133 | 5597334263 | 5592052010 |
| Street Address |
2139 E BEECHWOOD AVE |
| City | FRESNO |
| State | CA |
| Zip Code | 93720-0340 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932184959 | Randi A Galli | Plastic Surgery | 2139 E Beechwood Ave, Fresno, CA 93720-0340 | 2005-12-13 |
| 1447898846 | Evan Khristine Mangubat | Physician Assistant | 2139 E Beechwood Ave, Fresno, CA 93720-0340 | 2019-12-16 |
| 1649603036 | Eric Matthew Wagoner | Physician Assistant | 2139 E Beechwood Ave, Fresno, CA 93720-0340 | 2013-08-21 |
| 1972828812 | Ryan Carl Stehr | Surgery | 2139 E Beechwood Ave, Fresno, CA 93720-0340 | 2010-04-04 |
| 1154559441 | Michael Scot Reith | Occupational Therapist | 2139 E Beechwood Ave, Fresno, CA 93720-0340 | 2009-06-25 |
| 1073756235 | Ileana Cervantes | Physician Assistant | 2139 E Beechwood Ave, Fresno, CA 93720-0340 | 2009-04-16 |
| 1902043458 | Nathan Healy | Physician Assistant | 2139 E Beechwood Ave, Fresno, CA 93720-0340 | 2009-01-20 |
| 1891964383 | Bethany Herblet | Occupational Therapist | 2139 E Beechwood Ave, Fresno, CA 93720-0340 | 2008-02-28 |
| 1114903648 | Ricardo Avena | Orthopaedic Surgery | 2139 E Beechwood Ave, Fresno, CA 93720-0340 | 2005-12-16 |
| 1629054309 | Steven Goss | Physician Assistant | 2139 E Beechwood Ave, Fresno, CA 93720-0340 | 2005-12-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366061129 | Ariel Lok Yen Leung | Student in an Organized Health Care Education/Training Program | 1313 East Herndon Ave, St 105, Fresno, CA 93720 | 2020-04-13 |
| 1457992513 | Brittany Nichole Willis | Audiologist | 1351 E Spruce Ave Ste 130, Fresno, CA 93720 | 2019-09-30 |
| 1013567668 | Taylor Courteney Cox | Physical Therapist | 7080 N. Maple Ave #101, Fresno, CA 93720 | 2019-09-16 |
| 1457909152 | Lillian M Augilera | Technician | 8419 N Dearing Ave, Fresno, CA 93720 | 2019-08-27 |
| 1215581764 | Sterling Hospitalist Medical Group, Inc. | Clinic/Center | 1191 E. Herndon Avenue Suite 103, Fresno, CA 93720 | 2019-08-01 |
| 1376006429 | Nancy Minh Thao Dang | Student in an Organized Health Care Education/Training Program | 1313 E. Herndon Ave, St 105, Fresno, CA 93720 | 2019-04-06 |
| 1366904716 | Shankar Nair | Student in an Organized Health Care Education/Training Program | 1313 E. Herndon Ave, St 105., Fresno, CA 93720 | 2019-04-04 |
| 1861979544 | Powell Pediatric Dentistry Chestnut Partnership | Dentist | 7005 N. Chestnut Ave Ste 101, Fresno, CA 93720 | 2018-07-25 |
| 1669967311 | Sierra Pacific Orthopaedic Center Medical Group Inc | Specialist | 1270 E. Spruce, Fresno, CA 93720 | 2018-06-26 |
| 1689168700 | Vinita Vishnoi | Student in an Organized Health Care Education/Training Program | 1313 E. Herndon Ave, St 105, Fresno, CA 93720 | 2018-06-21 |
| Find all providers in zip 93720 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881972164 | Pamela Oliver | Physician Assistant | 1187 E Herndon Ave Ste 106, Fresno, CA 93720-3166 | 2011-08-03 |
| 1750505061 | Bounmy - Pinyasone | Physician Assistant | 141 N. Clark Street, Suite A, Fresno, CA 93701-2124 | 2007-04-11 |
| 1134253180 | Joseph John Contreras | Physician Assistant | 6065 N 1st St, Suite 102, Fresno, CA 93710-5469 | 2007-03-14 |
| 1083653729 | Sheri Lynn Oswald | Physician Assistant | 1646 E Herndon Ave, Suite 106, Fresno, CA 93720-3380 | 2006-06-06 |
| 1447247820 | Miriam Levitt | Physician Assistant | 4770 W Herndon Ave, Fresno, CA 93722-8401 | 2005-09-30 |
| 1285257063 | Blake Phillip Dreihaus | Physician Assistant | 2823 Fresno St, Fresno, CA 93721-1324 | 2020-05-27 |
| 1710509013 | Katherine Marie Pate | Physician Assistant | 2823 Fresno St, Fresno, CA 93721-1324 | 2020-05-11 |
| 1982187100 | Theresa Ann Dwyer | Physician Assistant | 2335 E Kashian Ln Ste 240, Fresno, CA 93701-2211 | 2018-09-13 |
| 1639699853 | Gabrielle Melissa Powell | Physician Assistant | 2210 E Illinois Ave Ste 201, Fresno, CA 93701-2184 | 2017-06-20 |
| 1891220323 | Amy Maier | Physician Assistant | 2823 Fresno St, Fresno, CA 93721-1324 | 2017-04-21 |
| Find all providers in FRESNO | ||||
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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.