Provider Demographics
NPI:1285428458
Name:GREEN, DYLAN (DC)
Entity type:Individual
Prefix:DR
First Name:DYLAN
Middle Name:
Last Name:GREEN
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2511 GARDEN RD STE C100
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-5333
Mailing Address - Country:US
Mailing Address - Phone:831-899-5900
Mailing Address - Fax:831-899-5958
Practice Address - Street 1:2511 GARDEN RD STE C100
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-5333
Practice Address - Country:US
Practice Address - Phone:831-899-5900
Practice Address - Fax:831-899-5958
Is Sole Proprietor?:No
Enumeration Date:2025-04-04
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC37192111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor