Provider Demographics
NPI:1326509696
Name:BETINA GREER MD INC
Entity Type:Organization
Organization Name:BETINA GREER MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BETINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GIDEON-GREER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-774-2942
Mailing Address - Street 1:4646 BROCKTON AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-0104
Mailing Address - Country:US
Mailing Address - Phone:951-774-2942
Mailing Address - Fax:951-774-2942
Practice Address - Street 1:4646 BROCKTON AVE STE 202
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-0104
Practice Address - Country:US
Practice Address - Phone:951-774-2942
Practice Address - Fax:951-774-2945
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BETINA GREER MD INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-03-28
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty