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General NPI Number Information
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NPI Number | 1164612776
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Entity Type | Organization
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Legal Business Name | BRUCE A WOODLING MD INC
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Dates
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Enumeration Date | 07/30/2007
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Last Update Date | 02/06/2024
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Provider Practice Location Address
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Address Line | 148 N BRENT ST STE 102
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City | VENTURA
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State | CA
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Zip | 93003-2825
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Country | US
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Telephone | 805-482-6643
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1088
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City | VENTURA
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State | CA
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Zip | 93002-1088
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Country | US
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Telephone | 805-482-6643
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Fax | 805-388-5546
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Authorized Official
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Title or Position | PRESIDENT
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Name | BRUCE A WOODLING
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Credential | MD
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Telephone | 805-482-6643
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | G24570
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License Number State | CA
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