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NPI Code Detail

MEDICARE: DARIUS LEE SEAN WOODS

MEDICARE:   DARIUS LEE SEAN WOODS
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
11710I1002XIndependent Duty Corpsman

General Provider Information

NPI Number : 1770180648
Entity Type Code : Individual
Provider Name (Legal Business Name) : DARIUS LEE SEAN WOODS
Provider Business Mailing Address
First Line : 6033 SANDY SHORE CT
Second Line :
City : SAN DIEGO
State : CA
Zip : 92139-1014
Country : US
Telephone Number : 318-655-3671
Fax Number :
Provider Business Practice Location Address
First Line : 6033 SANDY SHORE CT
Second Line :
City : SAN DIEGO
State : CA
Zip : 92139-1014
Country : US
Telephone Number : 318-655-3671
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2020
Last Update Date : 10/05/2020

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Directions to “ DARIUS LEE SEAN WOODS ” Practice Location

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