Provider Demographics
NPI:1013477843
Name:WOO, DENNIS MICHAEL
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:MICHAEL
Last Name:WOO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 E. TACHEVAH DR
Mailing Address - Street 2:SUITE 2E - 204
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262
Mailing Address - Country:US
Mailing Address - Phone:760-561-7327
Mailing Address - Fax:760-307-8172
Practice Address - Street 1:555 E. TACHEVAH DR
Practice Address - Street 2:SUITE 2E - 204
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262
Practice Address - Country:US
Practice Address - Phone:760-561-7327
Practice Address - Fax:760-307-8172
Is Sole Proprietor?:No
Enumeration Date:2019-03-19
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA176999207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine