Healthcare Provider Details

I. General information

NPI: 1023272788
Provider Name (Legal Business Name): ARTIS WOODWARD MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2008
Last Update Date: 07/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2120 W 8TH ST #330
LOS ANGELES CA
90057-4019
US

IV. Provider business mailing address

2120 W 8TH ST #330
LOS ANGELES CA
90057-4019
US

V. Phone/Fax

Practice location:
  • Phone: 213-385-2400
  • Fax: 213-385-2403
Mailing address:
  • Phone: 213-385-2400
  • Fax: 213-385-2403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberA40488
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberA40488
License Number StateCA

VIII. Authorized Official

Name: ARTIS WOODWARD
Title or Position: PRESIDENT
Credential: MD
Phone: 213-385-2400