Mark Wood

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA64343 Issued in CA

Practice address

5000 Van Nuys Blvd Ste 205
Sherman Oaks, CA 91403-1717

Phone

(818) 850-2243

Fax

(661) 360-6380

NPI assigned

Nov 27, 2023

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: mark.wood@709.securemail.prognocis.com

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1701043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1003682410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 VAN NUYS BLVD STE 205",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031717",
            "fax_number": "661-360-6380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 VAN NUYS BLVD STE 205",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031717",
            "telephone_number": "818-850-2243",
            "fax_number": "661-360-6380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "MARK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-27",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA64343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Wong, PHARMD
• Marissa Hatsue Wong
• William Wong, PHARM.D.
• Parichut Wongkhoomngern
• David Wood, L.AC.
• Jaylen Joseph Woodard
• Jada Noelle Woods I
• Maci Woodson, MSN, FNP-BC
• Angela A Woolard
• Working With Autism, Inc.

• Physician Assistant in Sherman Oaks, CA
• Providers in Sherman Oaks, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.