MEDICARE: DR. CORRINE KIMBERLY 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
1	122300000X	Dentist	40514	CA

General Provider Information

NPI Number	:	1801957857
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CORRINE KIMBERLY WOO DDS

Provider Business Mailing Address
First Line	:	225 SPRUCE AVE
Second Line	:
City	:	SOUTH SAN FRANCISCO
State	:	CA
Zip	:	94080-3631
Country	:	US
Telephone Number	:	650-588-2466
Fax Number	:

Provider Business Practice Location Address
First Line	:	225 SPRUCE AVE
Second Line	:
City	:	SOUTH SAN FRANCISCO
State	:	CA
Zip	:	94080-3631
Country	:	US
Telephone Number	:	650-588-2466
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/13/2006
Last Update Date	:	08/04/2008

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