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Organization

WOODMAN MEDICAL CARE AND CLINIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JAMES A HARTLEROAD MD (OWNER)
(818) 988-9825
Entity
Organization

Contact information

Practice address
13653 VICTORY BLVD, VAN NUYS, CA 91401-1735
(818) 988-9825
Mailing address
13653 VICTORY BLVD, VAN NUYS, CA 91401-1735

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
00G749010
CA
208D00000X
General Practice Physician
00G749010
CA

Other

Enumeration date
05/25/2012
Last updated
05/25/2012
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