# WOODVIC MEDICAL CARE AND CLINIC, CORP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023343571
- **Authorized official:** MR. ALLA KOROLEVA (OWNER)
- **Authorized official phone:** (818) 988-9825

## Contact information

- **Practice address:** 13653 VICTORY BLVD, VAN NUYS, CA 91401-1735
- **Practice address phone:** (818) 988-9825
- **Practice address fax:** (818) 988-9305
- **Mailing address:** 13653 VICTORY BLVD, VAN NUYS, CA 91401-1735
- **Mailing address phone:** (818) 988-9825

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/15/2009
- **Last updated:** 02/22/2010