Provider Demographics
NPI:1609862333
Name:WOODRUFF, DAVID E JR (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:E
Last Name:WOODRUFF
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:10470 OLD PLACERVILLE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-2539
Mailing Address - Country:US
Mailing Address - Phone:800-470-0071
Mailing Address - Fax:
Practice Address - Street 1:2800 L ST
Practice Address - Street 2:6TH FLOOR
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-5616
Practice Address - Country:US
Practice Address - Phone:916-887-4040
Practice Address - Fax:916-887-4045
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2015-05-12
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Provider Licenses
StateLicense IDTaxonomies
CAC34162207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C341620Medicaid
CAP00069964OtherRAILROAD MEDICARE
CA00C341620Medicaid
CAA88991Medicare UPIN