Provider Demographics
NPI:1982602058
Name:WOODS, ROBERT L (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:L
Last Name:WOODS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 4892
Mailing Address - Street 2:
Mailing Address - City:LAGUNA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92652-4892
Mailing Address - Country:US
Mailing Address - Phone:714-547-4332
Mailing Address - Fax:714-547-4313
Practice Address - Street 1:19203 ANSEL
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-0169
Practice Address - Country:US
Practice Address - Phone:714-547-4332
Practice Address - Fax:714-547-4313
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-12
Last Update Date:2016-02-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG0752182084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF50646Medicare UPIN
CAG75218AMedicare PIN