Active NPI
Wooldridge Tissue Service, Inc
- Histology Specialist/Technologist
- Gardena, CA
National Provider Identifier
1013974385
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Histology Specialist/Technologist
- Legal business name
- WOOLDRIDGE TISSUE SERVICE, INC
- Practice address
- 15319 S Avalon Blvd
Gardena, CA 90248-2304 - Phone
- (209) 575-4575
- Fax
- (209) 575-4598
- NPI assigned
- Apr 28, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- June Adams
- Title
- Medical Billing Rep
- Phone
- (209) 575-4575
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Histology Specialist/Technologist | 246QH0600X | Primary |
Addresses
Primary practice location
15319 S Avalon Blvd
Gardena, CA 90248-2304
Mailing address
PO Box 4978
Modesto, CA 95352-4978
Phone (209) 575-4575
National Provider Directory
National Provider DirectoryLocations
414 W Redondo Beach Blvd
Ste A
Gardena, CA 90248
Phone (310) 323-1919
15319 S Avalon Blvd
Gardena, CA 90248
Phone (310) 323-1919
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146182400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1297036800000",
"number": "1013974385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4978",
"city": "MODESTO",
"state": "CA",
"postal_code": "953524978",
"telephone_number": "209-575-4575",
"fax_number": "209-575-4598"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15319 S AVALON BLVD",
"city": "GARDENA",
"state": "CA",
"postal_code": "902482304",
"telephone_number": "209-575-4575",
"fax_number": "209-575-4598"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WOOLDRIDGE TISSUE SERVICE, INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-04-28",
"last_updated": "2011-02-07",
"status": "A",
"authorized_official_last_name": "ADAMS",
"authorized_official_first_name": "JUNE",
"authorized_official_title_or_position": "MEDICAL BILLING REP",
"authorized_official_telephone_number": "209-575-4575"
},
"taxonomies": [
{
"code": "246QH0600X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist/Technologist, Pathology, Histology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Gardena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.