Provider Demographics
NPI:1609328905
Name:WOODS MEDICAL AND ASSOCIATES
Entity Type:Organization
Organization Name:WOODS MEDICAL AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:TEJON
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:916-747-5155
Mailing Address - Street 1:4262 LYND AVE
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-5834
Mailing Address - Country:US
Mailing Address - Phone:916-747-5155
Mailing Address - Fax:626-899-4440
Practice Address - Street 1:4262 LYND AVE
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-5834
Practice Address - Country:US
Practice Address - Phone:916-747-5155
Practice Address - Fax:626-899-4440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-03
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACANP 21303363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty