Provider Demographics
NPI:1174785372
Name:J WOODS MEDICAL SERVICES
Entity type:Organization
Organization Name:J WOODS MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODBURY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-325-5058
Mailing Address - Street 1:1730 SEPULVEDA BLVD STE 15
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-6915
Mailing Address - Country:US
Mailing Address - Phone:310-325-5058
Mailing Address - Fax:
Practice Address - Street 1:1730 SEPULVEDA BLVD STE 15
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501-6915
Practice Address - Country:US
Practice Address - Phone:310-325-5058
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-28
Last Update Date:2008-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6003880001Medicare NSC