| Doctor Name: | BRADLEY ALAN GREENE |
| NPI Number: | 1811098379 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | A74002 |
| Business Practice Address: | 3130 Alpine Rd Suite 195 Portola Valley, CA - 940287549 |
| Business Phone Number: | 6508510155 |
| Business Fax Number: | 6505290929 |
| Mailing Address: | 3130 Alpine Rd, Suite 195 PORTOLA VALLEY |
| State: | CA |
| Postal Code: | 940287549 |
| Phone Number: | 6508510155 |
| Fax Number: | 6505290929 |
| NPI Enumeration Date: | 09/26/2006 |
| NPI Last Update Date: | 07/08/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207YS0123X |
| License Number: | A74002 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Otolaryngology |
| Taxonomy Specialization: | Facial Plastic Surgery |
| Taxonomy Definition: | An otolaryngologist who specializes in facial plastic surgery. |