Provider Demographics
NPI:1740231885
Name:WOODBURN, JAMES D II (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:D
Last Name:WOODBURN
Suffix:II
Gender:M
Credentials:MD
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Mailing Address - Street 1:168 N BRENT ST
Mailing Address - Street 2:# 504 JAMES D WOODBURN II MD
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-2840
Mailing Address - Country:US
Mailing Address - Phone:805-643-3783
Mailing Address - Fax:805-643-0330
Practice Address - Street 1:168 N BRENT ST
Practice Address - Street 2:# 504 JAMES D WOODBURN II MD
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-2840
Practice Address - Country:US
Practice Address - Phone:805-643-3783
Practice Address - Fax:805-643-0330
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-13
Last Update Date:2024-03-09
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Provider Licenses
StateLicense IDTaxonomies
CAC34901208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC34901Medicare ID - Type Unspecified
A35496Medicare UPIN