Provider Demographics
NPI:1497859433
Name:GREENBERG, JAMES Y (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:Y
Last Name:GREENBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1730 16TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-4538
Mailing Address - Country:US
Mailing Address - Phone:415-753-8277
Mailing Address - Fax:415-292-0718
Practice Address - Street 1:2299 POST ST
Practice Address - Street 2:STE 205
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3441
Practice Address - Country:US
Practice Address - Phone:415-474-7955
Practice Address - Fax:415-292-0718
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA55519207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A555191Medicare ID - Type Unspecified
CAG47501Medicare UPIN