Provider Demographics
NPI:1083376016
Name:LINDA O WOODALL MD
Entity Type:Organization
Organization Name:LINDA O WOODALL MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:LINIDA
Authorized Official - Middle Name:O
Authorized Official - Last Name:WOODALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-235-0016
Mailing Address - Street 1:200 E DEL MAR BLVD STE 122
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-2551
Mailing Address - Country:US
Mailing Address - Phone:626-235-0016
Mailing Address - Fax:
Practice Address - Street 1:200 E DEL MAR BLVD STE 122
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-2551
Practice Address - Country:US
Practice Address - Phone:626-235-0016
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-07
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty