Provider Demographics
NPI:1730250465
Name:GREEN, ARLEN DAVID (DO)
Entity type:Individual
Prefix:DR
First Name:ARLEN
Middle Name:DAVID
Last Name:GREEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27882 FORBES RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-1267
Mailing Address - Country:US
Mailing Address - Phone:949-364-6888
Mailing Address - Fax:
Practice Address - Street 1:27882 FORBES RD
Practice Address - Street 2:SUITE 100
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-1267
Practice Address - Country:US
Practice Address - Phone:949-495-5252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A 9441208100000X
AZ5048208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine