Active NPI
Mark Adam Wood III
- Rehabilitation Practitioner
- Fontana, CA
National Provider Identifier
1770870214
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- Practice address
- 15723 Parkhouse Dr Unit 7
Fontana, CA 92336-6516 - Phone
- (559) 270-3534
- NPI assigned
- Jul 5, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | Primary |
Addresses
Primary practice location
15723 Parkhouse Dr Unit 7
Fontana, CA 92336-6516
Mailing address
15723 Parkhouse Dr Unit 7
Fontana, CA 92336-6516
Phone (559) 270-3534
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1313020800000",
"number": "1770870214",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15723 PARKHOUSE DR UNIT 7",
"city": "FONTANA",
"state": "CA",
"postal_code": "923366516",
"telephone_number": "559-270-3534"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15723 PARKHOUSE DR UNIT 7",
"city": "FONTANA",
"state": "CA",
"postal_code": "923366516",
"telephone_number": "559-270-3534"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOOD",
"first_name": "MARK",
"middle_name": "ADAM",
"name_prefix": "Mr.",
"name_suffix": "III",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-07-05",
"last_updated": "2011-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fontana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.