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General NPI Number Information
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NPI Number | 1265613749
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Entity Type | Organization
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Legal Business Name | LAWRENCE A WOOD M.D. A MEDICAL CORPORATION
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Dates
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Enumeration Date | 11/26/2007
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Last Update Date | 11/26/2007
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Provider Practice Location Address
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Address Line | 10531 4S COMMONS DR SUITE #168
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City | SAN DIEGO
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State | CA
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Zip | 92127-3517
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Country | US
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Telephone | 858-675-2020
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Fax | 858-675-2036
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Provider Business Mailing Address
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Address Line | 10531 4S COMMONS DR SUITE #168
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City | SAN DIEGO
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State | CA
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Zip | 92127-3517
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Country | US
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Telephone | 858-675-2020
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Fax | 858-675-2036
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Authorized Official
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Title or Position | PROVIDER/OWNER
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Name | DR. LAWRENCE ALVIN WOOD
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Credential | M.D.
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Telephone | 858-675-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | C43071
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License Number State | CA
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