Provider Demographics
NPI:1689832008
Name:WARREN WOO, M.D.
Entity Type:Organization
Organization Name:WARREN WOO, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:
Authorized Official - Last Name:WOO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-961-1635
Mailing Address - Street 1:1275 N ROSE DR STE 138
Mailing Address - Street 2:
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92870-3919
Mailing Address - Country:US
Mailing Address - Phone:714-961-1635
Mailing Address - Fax:714-961-1679
Practice Address - Street 1:1275 N ROSE DR STE 138
Practice Address - Street 2:
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-3919
Practice Address - Country:US
Practice Address - Phone:714-961-1635
Practice Address - Fax:714-961-1679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-02
Last Update Date:2008-11-10
Deactivation Date:2008-08-14
Deactivation Code:
Reactivation Date:2008-11-10
Provider Licenses
StateLicense IDTaxonomies
CAC40927207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
A37478Medicare UPIN
C40927Medicare PIN