Provider Demographics
NPI:1407185911
Name:RACHEL WOOD DPM
Entity Type:Organization
Organization Name:RACHEL WOOD DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:408-263-8141
Mailing Address - Street 1:500 E CALAVERAS BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-7703
Mailing Address - Country:US
Mailing Address - Phone:408-263-8141
Mailing Address - Fax:408-263-4746
Practice Address - Street 1:500 E CALAVERAS BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-7703
Practice Address - Country:US
Practice Address - Phone:408-263-8141
Practice Address - Fax:408-263-4746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-11
Last Update Date:2009-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE26400213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty