Active NPI
Roger S Woodard, MD
- Emergency Medicine Physician
- Whittier, CA
National Provider Identifier
1023054798
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- C37338
- Practice address
- 12401 Washington Blvd
Whittier, CA 90602-1006 - Phone
- (562) 698-0811
- Fax
- (818) 587-2493
- NPI assigned
- Jun 21, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | C37338 | CA | Primary |
Addresses
Primary practice location
12401 Washington Blvd
Whittier, CA 90602-1006
Mailing address
PO Box 4419
Woodland Hills, CA 91365-4419
Phone (800) 506-6895
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00C373380 | Other | CA | BLUE SHIELD |
| 00C373380 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37338 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1023054798",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4419",
"city": "WOODLAND HILLS",
"state": "CA",
"postal_code": "913654419",
"telephone_number": "800-506-6895",
"fax_number": "818-587-2493"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12401 WASHINGTON BLVD",
"city": "WHITTIER",
"state": "CA",
"postal_code": "906021006",
"telephone_number": "562-698-0811",
"fax_number": "818-587-2493"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOODARD",
"first_name": "ROGER",
"middle_name": "S",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "CA",
"license": "C37338",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "00C373380",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00C373380",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Whittier, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.