Provider Demographics
NPI:1376632596
Name:GREER, JAMES M (DPM)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:M
Last Name:GREER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:350 JOHN MUIR PKWY
Mailing Address - Street 2:SUITE 225
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513
Mailing Address - Country:US
Mailing Address - Phone:925-516-1551
Mailing Address - Fax:925-516-4145
Practice Address - Street 1:350 JOHN MUIR PKWY
Practice Address - Street 2:SUITE 225
Practice Address - City:BRENTWOOD
Practice Address - State:CA
Practice Address - Zip Code:94513
Practice Address - Country:US
Practice Address - Phone:925-516-1551
Practice Address - Fax:925-516-4145
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2011-04-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAE4225213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E42250Medicaid
CA1304470001Medicare NSC
CA000E42250Medicaid
CAU75795Medicare UPIN