Healthcare Provider Details

I. General information

NPI: 1669670832
Provider Name (Legal Business Name): DANIEL K. WOO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2007
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4511 ROSEMEAD BLVD
PICO RIVERA CA
90660-2032
US

IV. Provider business mailing address

1121 CORONET DR
RIVERSIDE CA
92506-5606
US

V. Phone/Fax

Practice location:
  • Phone: 562-692-3388
  • Fax: 281-664-3522
Mailing address:
  • Phone: 203-982-8789
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberA77985
License Number StateCA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier10199.9280001
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer
# 2
Identifier039818
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerMEDICARE GROUP
# 3
Identifier02907808
Identifier TypeMEDICAID
Identifier StateNY
Identifier Issuer
# 4
Identifier166967832
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: