Organization Active NPI

Wooldridge Tissue Service, Inc

  • Histology Specialist/Technologist
  • Gardena, CA
National Provider Identifier
1013974385
Registry record updated Feb 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Histology Specialist/TechnologistTaxonomy code 246QH0600X
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

Updated by the provider on Feb 7, 2011

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)CodeLicenseStatePrimary
Histology Specialist/TechnologistGroup: 193400000X SINGLE SPECIALTY GROUP 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 Directory

Locations

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.

Verify at the official NPI Registry.