# WILSHIRE MEDICAL CLINIC

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

## Provider details

- **NPI number:** 1669795431
- **Authorized official:** ARTIS WOODWARD M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (213) 387-8402

## Contact information

- **Practice address:** 3540 WILSHIRE BLVD, SUITE: 1014, LOS ANGELES, CA 90010-2307
- **Practice address phone:** (213) 387-8024
- **Practice address fax:** (213) 387-8916
- **Mailing address:** 3540 WILSHIRE BLVD, SUITE: 1014, LOS ANGELES, CA 90010-2307
- **Mailing address phone:** (213) 387-8024
- **Mailing address fax:** (213) 387-8916

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204C00000X | Sports Medicine (Neuromusculoskeletal Medicine) Physician | A102066 | CA | — |
| 207L00000X | Anesthesiology Physician | A40408 | CA | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |
| 207X00000X | Orthopaedic Surgery Physician | A10037 | CA | — |
| 207Y00000X | Otolaryngology Physician | G36302 | CA | — |

## Other

- **Enumeration date:** 03/09/2010
- **Last updated:** 03/09/2010