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1043531676
MACK GREEN
APPLE VALLEY, CA
NPI
1043531676
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207QS0010X Family Medicine Sports Medicine
(Licence: CA A1259029)
Enumeration Date
2010-06-17
Last Update Date
2015-09-28
Business Address
MACK GREEN MD
16008 KAMANA RD SUITE 100
APPLE VALLEY, CA 92307-1376
Phone number: 760-956-5200
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Mailing Address
MACK GREEN MD
12277 APPLE VALLEY RD PMB 288
APPLE VALLEY, CA 92308-1701
Phone number: 760-956-5200
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