Healthcare Provider Details

I. General information

NPI: 1760536163
Provider Name (Legal Business Name): LARRY HOWARD WOODCOX DPM ,DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 01/10/2011
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 STE 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:
Title or Position:
Credential:
Phone: