Healthcare Provider Details

I. General information

NPI: 1407185911
Provider Name (Legal Business Name): RACHEL WOOD DPM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2009
Last Update Date: 12/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 E CALAVERAS BLVD SUITE 100
MILPITAS CA
95035-7703
US

IV. Provider business mailing address

500 E CALAVERAS BLVD SUITE 100
MILPITAS CA
95035-7703
US

V. Phone/Fax

Practice location:
  • Phone: 408-263-8141
  • Fax: 408-263-4746
Mailing address:
  • Phone: 408-263-8141
  • Fax: 408-263-4746

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberE26400
License Number StateCA

VIII. Authorized Official

Name: RACHEL WOOD
Title or Position: OWNER
Credential: DPM
Phone: 408-263-8141