Brian M. Woo, D.d.s., M.d., Inc. | |
290 North Wayte Lane Fresno CA 93701-1324 | |
(559) 459-5120 | |
Not Available |
Full Name | Brian M. Woo, D.d.s., M.d., Inc. |
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Speciality | Oral & Maxillofacial Surgery |
Location | 290 North Wayte Lane, Fresno, California |
Authorized Official Name and Position | Brian Michael Woo (PRESIDENT/OWNER) |
Authorized Official Contact | 5594595120 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Brian M. Woo, D.d.s., M.d., Inc. 290 North Wayte Lane Fresno CA 93701-1324 Ph: (559) 459-5120 | Brian M. Woo, D.d.s., M.d., Inc. 290 North Wayte Lane Fresno CA 93701-1324 Ph: (559) 459-5120 |
NPI Number | 1982838579 |
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Provider Enumeration Date | 05/11/2009 |
Last Update Date | 03/07/2023 |
Medicare PECOS PAC ID | 5092853689 |
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Medicare Enrollment ID | O20091119000476 |
Identifier | Type | State | Issuer |
---|---|---|---|
1982838579 | NPI | - | NPPES |
GA 1484 | Other | CA | GENERAL ANESTHESIA LICENSE |
A107428 | Other | CA | MEDICAL LICENSE |
50017 | Other | CA | DENTAL LICENSE |
Provider Name | Brian M Woo |
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Provider Type | Practitioner - Oral Surgery |
Provider Identifiers | NPI Number: 1558579144 PECOS PAC ID: 8022156611 Enrollment ID: I20091119000455 |
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