Woodvic Medical Management, Inc

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

G74901 Issued in CA

Legal business name

WOODVIC MEDICAL MANAGEMENT, INC

Practice address

13653 Victory Blvd
Van Nuys, CA 91401-1735

Phone

(818) 988-9825

Fax

(818) 988-9305

NPI assigned

Sep 19, 2012

Organization subpart

No

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

Authorized official

Name

James Hartleroad, MD

Title

Doctor

Phone

(818) 988-9825

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1348012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348012800000",
    "number": "1518218379",
    "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",
            "telephone_number": "818-988-9825",
            "fax_number": "818-988-9305"
        },
        {
            "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",
            "fax_number": "818-988-9305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODVIC MEDICAL MANAGEMENT, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-19",
        "last_updated": "2012-09-19",
        "status": "A",
        "authorized_official_last_name": "HARTLEROAD",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "818-988-9825",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G74901",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "CA",
            "license": "G74901",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "G74901",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bonnie Lou Wood
• Woodman Healthcare Center LLC
• Woodman Medical Care and Clinic
• Woodvic Medical Care and Clinic
• Woodvic Medical Care and Clinic, Corp
• Samuel Grayson Woolf
• World Class Home Healthcare Inc
• World Class Hospice Inc
• Mark William Worrell
• Wound Care Specialists Inc

• Surgery Physician in Van Nuys, CA
• Providers in Van Nuys, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.