NPIMap

Organization Active NPI

Woodman Medical Care and Clinic

  • Surgery Physician
  • Van Nuys, CA
National Provider Identifier
1205196094
Registry record updated May 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
00G749010 Issued in CA
Legal business name
WOODMAN MEDICAL CARE AND CLINIC
Practice address
13653 Victory Blvd
Van Nuys, CA 91401-1735
Phone
(818) 988-9825
NPI assigned
May 25, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2012

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

Authorized official

Name
James A Hartleroad, MDNPI 1336189067
Title
Owner
Phone
(818) 988-9825

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X 00G749010 CA Primary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X 00G749010 CA

Addresses

Primary practice location

13653 Victory Blvd
Van Nuys, CA 91401-1735

Mailing address

13653 Victory Blvd
Van Nuys, CA 91401-1735

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1337904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337904000000",
    "number": "1205196094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13653 VICTORY BLVD",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914011735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13653 VICTORY BLVD",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914011735",
            "telephone_number": "818-988-9825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODMAN MEDICAL CARE AND CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-25",
        "last_updated": "2012-05-25",
        "status": "A",
        "authorized_official_last_name": "HARTLEROAD",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-988-9825",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "CA",
            "license": "00G749010",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "00G749010",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2012; 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.