Healthcare Provider Details

I. General information

NPI: 1790489946
Provider Name (Legal Business Name): CLARA WOODS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2023
Last Update Date: 08/29/2026
Certification Date: 08/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 MILVIA ST
BERKELEY CA
94704-2636
US

IV. Provider business mailing address

73 HARRISON AVE
CHERRY HILL NJ
08002-3519
US

V. Phone/Fax

Practice location:
  • Phone: 609-727-8025
  • Fax:
Mailing address:
  • Phone: 609-727-8025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA210115
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: