Provider Demographics
NPI:1760536163
Name:WOODCOX, LARRY HOWARD (DPM ,DC)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:HOWARD
Last Name:WOODCOX
Suffix:
Gender:M
Credentials:DPM ,DC
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Mailing Address - Street 1:1624 FRANKLIN ST STE 510
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-2823
Mailing Address - Country:US
Mailing Address - Phone:510-251-0330
Mailing Address - Fax:510-251-0344
Practice Address - Street 1:1624 FRANKLIN ST STE 510
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-2823
Practice Address - Country:US
Practice Address - Phone:510-251-0330
Practice Address - Fax:510-251-0344
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAE2031213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5591890001Medicare NSC
CAT11143Medicare UPIN