Provider Demographics
NPI:1588609572
Name:WOO, JEAN (MD MPH MBA)
Entity Type:Individual
Prefix:MS
First Name:JEAN
Middle Name:
Last Name:WOO
Suffix:
Gender:F
Credentials:MD MPH MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1442A WALNUT ST # 368
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94709-1405
Mailing Address - Country:US
Mailing Address - Phone:510-295-3531
Mailing Address - Fax:
Practice Address - Street 1:1001 POTRERO AVENUE, WARD 94
Practice Address - Street 2:SAN FRANCISCO GENERAL HOSPITAL
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110
Practice Address - Country:US
Practice Address - Phone:415-206-8524
Practice Address - Fax:415-206-4565
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG51082207Q00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
00G510820Medicare ID - Type Unspecified
F24172Medicare UPIN