Healthcare Provider Details

I. General information

NPI: 1942210620
Provider Name (Legal Business Name): ROBERT D. WOOD, M.D., A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 04/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 N ROSE AVE
OXNARD CA
93030-3722
US

IV. Provider business mailing address

11999 SAN VICENTE BLVD #440
LOS ANGELES CA
90049-5131
US

V. Phone/Fax

Practice location:
  • Phone: 805-988-2500
  • Fax:
Mailing address:
  • Phone: 310-440-3131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberA35463
License Number StateCA

VIII. Authorized Official

Name: DR. ROBERT D. WOOD
Title or Position: PRESIDENT
Credential: M.D.
Phone: 310-440-3131