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General NPI Number Information
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NPI Number | 1033568019
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Entity Type | Individual
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Provider Name | MICHAEL WOOD
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Gender | Male
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Dates
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Enumeration Date | 06/09/2016
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Last Update Date | 06/09/2016
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Provider Practice Location Address
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Address Line | 502 N ELECTRIC AVE APT D
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City | ALHAMBRA
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State | CA
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Zip | 91801-2045
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Country | US
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Telephone | 510-290-0586
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Fax |
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Provider Business Mailing Address
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Address Line | 502 N ELECTRIC AVE APT D
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City | ALHAMBRA
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State | CA
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Zip | 91801-2045
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Country | US
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Telephone | 510-290-0586
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TE1100X
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Taxonomy Name | Exercise & Sports Psychologist
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License Number |
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Taxonomy #2
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number |
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Taxonomy #3
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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Taxonomy #5
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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Taxonomy #6
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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Taxonomy #7
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Taxonomy Code | 225800000X
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Taxonomy Name | Recreation Therapist
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Taxonomy #8
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Taxonomy Code | 225XE1200X
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Taxonomy Name | Ergonomics Occupational Therapist
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License Number |
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Taxonomy #9
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Taxonomy Code | 225XG0600X
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Taxonomy Name | Gerontology Occupational Therapist
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