Healthcare Provider Details

I. General information

NPI: 1063131852
Provider Name (Legal Business Name): CRAIG WOO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2022
Last Update Date: 07/11/2025
Certification Date: 07/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28202 CABOT RD STE 105
LAGUNA NIGUEL CA
92677-1247
US

IV. Provider business mailing address

28202 CABOT RD STE 105
LAGUNA NIGUEL CA
92677-1247
US

V. Phone/Fax

Practice location:
  • Phone: 949-364-2900
  • Fax: 949-365-0117
Mailing address:
  • Phone: 949-364-2900
  • Fax: 949-365-0117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: