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NPI Code Detail

MEDICARE: DR. MABLE WOO O.D.

MEDICARE:  DR. MABLE  WOO  O.D.
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
1152W00000XOptometrist1145AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1689734543
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MABLE WOO O.D.
Provider Business Mailing Address
First Line : 3120 E UNION HILLS DR
Second Line : SUITE 105
City : PHOENIX
State : AZ
Zip : 85050-3421
Country : US
Telephone Number : 602-867-4200
Fax Number : 602-867-4450
Provider Business Practice Location Address
First Line : 3120 E UNION HILLS DR
Second Line : SUITE 105
City : PHOENIX
State : AZ
Zip : 85050-3421
Country : US
Telephone Number : 602-867-4200
Fax Number : 602-867-4450
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2006
Last Update Date : 07/09/2007

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Directions to “ DR. MABLE WOO O.D.” Practice Location

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