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1235917196
CHANEL GREEN
COSTA MESA, CA
NPI
1235917196
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2023-09-20
Last Update Date
2024-08-29
Business Address
CHANEL GREEN PA-C
700 W 19TH ST
COSTA MESA, CA 92627-3517
Phone number: 949-866-3600
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Mailing Address
CHANEL GREEN PA-C
700 W 19TH ST
COSTA MESA, CA 92627-3517
Phone number: 949-866-3600
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