Southland Medical Group,LLC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

A40488 Issued in CA

Legal business name

SOUTHLAND MEDICAL GROUP,LLC

Practice address

17870 Newhope St., Suite 104-276
Fountain Valley, CA 92708

Phone

(171) 463-6373

NPI assigned

Dec 18, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Artis Woodward, MD

Title

Director

Phone

(714) 636-3736

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1387324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387324800000",
    "number": "1295156271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17870 NEWHOPE ST., SUITE 104-276",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "92708",
            "telephone_number": "171-463-6373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17870 NEWHOPE ST., SUITE 104-276",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "92708",
            "telephone_number": "171-463-6373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHLAND MEDICAL GROUP,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-18",
        "last_updated": "2013-12-18",
        "status": "A",
        "authorized_official_last_name": "WOODWARD",
        "authorized_official_first_name": "ARTIS",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "714-636-3736",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A40488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Anesthesiology Physician in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2013; 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.