Provider Demographics
NPI:1134198930
Name:WOO, PAUL T (OD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:T
Last Name:WOO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1234 S. GARFIELD AVE
Mailing Address - Street 2:#105
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-5068
Mailing Address - Country:US
Mailing Address - Phone:626-282-5388
Mailing Address - Fax:626-282-3667
Practice Address - Street 1:1234 S. GARFIELD AVE
Practice Address - Street 2:#105
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-5068
Practice Address - Country:US
Practice Address - Phone:626-282-5388
Practice Address - Fax:626-282-3667
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA8905T152WP0200X, 152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0089050Medicaid
CAT70291Medicare UPIN