Healthcare Provider Details

I. General information

NPI: 1487747291
Provider Name (Legal Business Name): DAVID LYNDEN WOOD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5901 E. 7TH STREET
LONG BEACH CA
90822
US

IV. Provider business mailing address

P.O. BOX 8475
LONG BEACH CA
90808
US

V. Phone/Fax

Practice location:
  • Phone: 562-826-5557
  • Fax: 562-826-5666
Mailing address:
  • Phone: 562-243-8872
  • Fax: 562-421-4471

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberA18630
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: