WALTER S GREEN MD MEDICAL CORPORATION
NPI 1114120243
Specialist in San Clemente, CA

Q: What is Walter S Green MD Medical Corporation's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Active since June 06, 2007

657 CAMINO DE LOS MARES STE 242, SAN CLEMENTE, CA 92673(949) 496-6066 Get Directions Write a Review

NPPES record last updated: January 10, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Walter S Green Md Medical Corporation NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WALTER S GREEN MD MEDICAL CORPORATION (NPI 1114120243) is a healthcare organization registered as a specialist in San Clemente, California and active in the NPI registry since June 2007. The organization lists Walter S Green, Medical Doctor, as its authorized official.

NPPES Registry Identity

NPI1114120243

Entity TypeOrganization

Primary Taxonomy174400000X

Legal Business NameWALTER S GREEN MD MEDICAL CORPORATION

Location Address657 CAMINO DE LOS MARES STE 242San Clemente, CA 92673-2811

Mailing Address657 Camino De Los Mares Ste 242San Clemente, CA 92673-2811 · (949) 496-6066

Phone(949) 496-6066

Organization SubpartNo

Authorized OfficialWalter S GreenMedical Doctor · (949) 496-6066

Enumeration DateJune 6, 2007

Last NPPES UpdateJanuary 10, 2009

✔ NPI 1114120243 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

License✔ Licensed in CA · A09766

Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

657 CAMINO DE LOS MARES STE 242, San Clemente, CA 92673

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Other Identifiers 2

Medicare ID-Type UnspecifiedA09766ACA

Medicare UPINA18313CA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GREEN DERMATOLOGIC MEDICAL GROUP A MEDICAL CORPORATION

Specialist

657 CAMINO DE LOS MARES STE 242
SAN CLEMENTE, CA 92673

Orange County (949) 496-6066

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Walter S Green MD Medical Corporation's NPI number?

The NPI number for Walter S Green MD Medical Corporation is 1114120243. It was assigned to this organization in the NPPES registry on June 6, 2007.

Where is Walter S Green MD Medical Corporation located?

Walter S Green MD Medical Corporation is located at 657 Camino De Los Mares Ste 242, San Clemente, CA 92673. The listed phone number is (949) 496-6066.

What is Walter S Green MD Medical Corporation's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Walter S Green MD Medical Corporation was last updated on January 10, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.