=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336911999
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THE DO DOCTORS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/26/2023
-----------------------------------------------------
Last Update Date | 10/26/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2569 W FLORIDA AVE # 2569
-----------------------------------------------------
City | HEMET
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92545-4615
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-925-3635
-----------------------------------------------------
Fax | 951-758-8355
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2569 W FLORIDA AVE # 2569
-----------------------------------------------------
City | HEMET
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92545-4615
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-925-3635
-----------------------------------------------------
Fax | 951-758-8355
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DOCTOR & MOBILE MEDICAL DIRRECTOR
-----------------------------------------------------
Name | DR. QUINCY TREMAYNE WOODS
-----------------------------------------------------
Credential | DNP, MSO, FNP, DOMP
-----------------------------------------------------
Telephone | 951-925-3635
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------