Healthcare Provider Details

I. General information

NPI: 1063410322
Provider Name (Legal Business Name): ELIZABETH A WOODS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2005
Last Update Date: 04/07/2021
Certification Date: 04/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2335 E KASHIAN LN SUITE 450
FRESNO CA
93701-2230
US

IV. Provider business mailing address

PO BOX 399442
SAN FRANCISCO CA
94139-9442
US

V. Phone/Fax

Practice location:
  • Phone: 559-233-7700
  • Fax:
Mailing address:
  • Phone: 559-451-3699
  • Fax: 559-451-3661

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA48104
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA48104
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: