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NPI Code Detail

MEDICARE: DR. WON S WOO DDS

MEDICARE: DR. WON S WOO DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry28263CA

General Provider Information

NPI Number : 1154475234
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WON S WOO DDS
Provider Business Mailing Address
First Line : 3566 W 3RD ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90020-2013
Country : US
Telephone Number : 213-487-3621
Fax Number : 213-487-4062
Provider Business Practice Location Address
First Line : 3566 W 3RD ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90020-2013
Country : US
Telephone Number : 213-487-3621
Fax Number : 213-487-4062
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2007
Last Update Date : 07/09/2007

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Directions to “ DR. WON S WOO DDS” Practice Location

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