Provider Demographics
NPI:1003834243
Name:WOOD, DAVID LYMAN (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:LYMAN
Last Name:WOOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 E WASHINGTON ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-7111
Mailing Address - Country:US
Mailing Address - Phone:909-433-3200
Mailing Address - Fax:909-424-0307
Practice Address - Street 1:900 E WASHINGTON ST
Practice Address - Street 2:SUITE 100
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324-7111
Practice Address - Country:US
Practice Address - Phone:909-433-3200
Practice Address - Fax:909-424-0307
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG46774207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery