Organization
GREG WOODWORTH OD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREG K WOODWORTH OD (OPTOMETRIST OWNER)
(619) 447-5555
Entity
Organization
Contact information
Practice address
575 FLETCHER PKWY, EL CAJON, CA 92020-2522
(619) 447-5555
(619) 447-5089
Mailing address
575 FLETCHER PKWY, EL CAJON, CA 92020-2522
(619) 447-5555
(619) 447-5089
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
7606TPA
CA
156FC0800X
Contact Lens Technician/Technologist
7606TPA
CA
156FC0801X
Contact Lens Fitter
7606TPA
CA
156FX1800X
Optician
7606TPA
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16377
MEDICAL EYE SERVICES
CA
01
—
46555
SAFEGUARD HMO
CA
01
—
50301
SAFEGUARD PPO
CA
05
—
SD0076060
—
CA
Enumeration date
02/05/2007
Last updated
06/02/2008
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