Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mack Green, MD

Individual provider Sports Medicine (Family Medicine) Physician · NPI 1043531676

Mack Green, MD is a Sports Medicine in Apple Valley, California. Qualified in 2008, 18 years ago. Practices with Southern California Bone and Joint Clinic Inc, a 2-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
18
Licensed in
CA
In the registry since
2010
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

16008 Kamana Rd Ste 100
Apple Valley, CA 92307-1376
Phone: (760) 956-5200
Fax: (760) 669-0793
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Sports Medicine (Family Medicine) Physician (primary) Taxonomy 207QS0010X · Licence A1259029 (CA)

Record details

NPI number1043531676
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 17, 2010
Last updated in NPPESSeptember 28, 2015
Mailing address12277 Apple Valley Rd, Pmb 288, Apple Valley, CA 92308-1701

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtySPORTS MEDICINE
Also practisesFAMILY PRACTICE
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Southern California Bone And Joint Clinic Inc — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare