Provider Demographics
NPI:1447340336
Name:WOO, WARREN (MD)
Entity type:Individual
Prefix:DR
First Name:WARREN
Middle Name:
Last Name:WOO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1233 W GARDENA BLVD
Mailing Address - Street 2:#205 PRACTI-CAL SOLUTIONS INC
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90247
Mailing Address - Country:US
Mailing Address - Phone:310-327-9966
Mailing Address - Fax:310-327-9963
Practice Address - Street 1:1275 N ROSE DR
Practice Address - Street 2:SUITE 138
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-3941
Practice Address - Country:US
Practice Address - Phone:714-961-1635
Practice Address - Fax:714-961-1679
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2011-09-30
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Provider Licenses
StateLicense IDTaxonomies
CAC40927207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A37478Medicare UPIN
C40927Medicare ID - Type Unspecified