Provider Demographics
NPI:1205860657
Name:CHRISTOPHER O'REILLY-GREEN M.D.
Entity Type:Organization
Organization Name:CHRISTOPHER O'REILLY-GREEN M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OB-GYNECOLOGY
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:O'REILLY-GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:2095-268-3832
Mailing Address - Street 1:120 W. GRANGER AVENUE
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350
Mailing Address - Country:US
Mailing Address - Phone:209-526-3832
Mailing Address - Fax:
Practice Address - Street 1:2209 COFFEE RD STE M
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355
Practice Address - Country:US
Practice Address - Phone:209-526-8038
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC50372207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty