Provider Demographics
NPI:1568899904
Name:WOODS, ELENA LEODI (SFIDC)
Entity Type:Individual
Prefix:MRS
First Name:ELENA
Middle Name:LEODI
Last Name:WOODS
Suffix:
Gender:F
Credentials:SFIDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31033 CORTE ALAMAR
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-5401
Mailing Address - Country:US
Mailing Address - Phone:619-251-0043
Mailing Address - Fax:
Practice Address - Street 1:31033 CORTE ALAMAR
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-5401
Practice Address - Country:US
Practice Address - Phone:619-251-0043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-30
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman