Healthcare Provider Details

I. General information

NPI: 1609132489
Provider Name (Legal Business Name): LARRY H. WOODCOX DPM APC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2012
Last Update Date: 04/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1624 FRANKLIN ST. STE 510
OAKLAND CA
94612-2823
US

IV. Provider business mailing address

1624 FRANKLIN ST. #510
OAKLAND CA
94612-2823
US

V. Phone/Fax

Practice location:
  • Phone: 510-251-0330
  • Fax: 510-251-0344
Mailing address:
  • Phone: 510-251-0330
  • Fax: 510-251-0344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE2031
License Number StateCA

VIII. Authorized Official

Name: DR. LARRY HOWARD WOODCOX
Title or Position: PRESIDENT
Credential: DPM
Phone: 510-251-0330