=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851501977
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DAVID K. WOODRUFF AU.D
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/24/2007
-----------------------------------------------------
Last Update Date | 10/08/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6037 LA GRANADA SUITE D
-----------------------------------------------------
City | RANCHO SANTA FE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92067-0524
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 858-759-8922
-----------------------------------------------------
Fax | 858-759-8022
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 524
-----------------------------------------------------
City | RANCHO SANTA FE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92067-0524
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 858-759-8922
-----------------------------------------------------
Fax | 858-759-8022
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 237600000X
-----------------------------------------------------
Taxonomy Name | Audiologist-Hearing Aid Fitter
-----------------------------------------------------
License Number | AU1111, HA2516
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 237600000X
-----------------------------------------------------
Taxonomy Name | Audiologist-Hearing Aid Fitter
-----------------------------------------------------
License Number | AU1111
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------