Provider Demographics
NPI:1790183838
Name:GREEN MEDICAL ENTERPRISES INC
Entity type:Organization
Organization Name:GREEN MEDICAL ENTERPRISES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANHUI
Authorized Official - Middle Name:
Authorized Official - Last Name:XIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-996-9243
Mailing Address - Street 1:7385 RAINBOW DR APT 5
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-5345
Mailing Address - Country:US
Mailing Address - Phone:650-996-9243
Mailing Address - Fax:888-899-7561
Practice Address - Street 1:1309 S MARY AVE
Practice Address - Street 2:206
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-3050
Practice Address - Country:US
Practice Address - Phone:650-996-5392
Practice Address - Fax:888-899-7561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-05
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15210171100000X, 171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty