Healthcare Provider Details

I. General information

NPI: 1780609479
Provider Name (Legal Business Name): ROBERT WOOD MD APC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 02/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 E CARRILLO ST
SANTA BARBARA CA
93101-1460
US

IV. Provider business mailing address

PO BOX 7001
TARZANA CA
91357-7001
US

V. Phone/Fax

Practice location:
  • Phone: 805-957-1067
  • Fax:
Mailing address:
  • Phone: 818-888-7815
  • Fax: 818-715-1722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA35463
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberA35463
License Number StateCA

VIII. Authorized Official

Name: ROBERT WOOD
Title or Position: SOLE OWNER
Credential: MD
Phone: 818-888-7815