Provider Demographics
NPI:1538432257
Name:GREEN ONION PRODUCTIONS LLC
Entity type:Organization
Organization Name:GREEN ONION PRODUCTIONS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CLIFF
Authorized Official - Middle Name:J
Authorized Official - Last Name:TVETER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-408-5756
Mailing Address - Street 1:810 DILLON DR
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84404-6638
Mailing Address - Country:US
Mailing Address - Phone:925-408-5756
Mailing Address - Fax:925-946-0762
Practice Address - Street 1:810 DILLON DR
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84404-6638
Practice Address - Country:US
Practice Address - Phone:925-408-5756
Practice Address - Fax:925-946-0762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-10
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1830OtherMEDICAL BOOKLET