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

Shannon Green

Individual provider Internal Medicine Physician · NPI 1306370150

Shannon Green is an Interventional Radiology in San Diego, California. Qualified in 2017, 9 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
9
Licensed in
CA
In the registry since
2017
Specialties on file
2
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Practice location Address checks out

200 W Arbor Dr # MC8425
San Diego, CA 92103-1911
Phone: (619) 543-3534
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence A160498 (CA)
Internal Medicine Physician Taxonomy 207R00000X · Licence A160498 (CA)

Record details

NPI number1306370150
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 19, 2017
Last updated in NPPESOctober 27, 2023
Certification dateOctober 3, 2021

Medicare enrollment

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

Medicare specialtyINTERVENTIONAL RADIOLOGY
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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