Provider Demographics
NPI:1205397841
Name:GREENE, JOHN PALMER II (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:PALMER
Last Name:GREENE
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:505 PARNASSUS AVENUE, M798
Mailing Address - Street 2:BOX 0114
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-0114
Mailing Address - Country:US
Mailing Address - Phone:415-476-3891
Mailing Address - Fax:415-476-3428
Practice Address - Street 1:505 PARNASSUS AVENUE, M798
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-0114
Practice Address - Country:US
Practice Address - Phone:415-476-3891
Practice Address - Fax:415-476-3428
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-27
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.074373207R00000X
390200000X
CAA1790682084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program