Organization
WOODVIC MEDICAL MANAGEMENT, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES HARTLEROAD MD (DOCTOR)
(818) 988-9825
Entity
Organization
Contact information
Practice address
13653 VICTORY BLVD, VAN NUYS, CA 91401-1735
(818) 988-9825
(818) 988-9305
Mailing address
13653 VICTORY BLVD, VAN NUYS, CA 91401-1735
(818) 988-9825
(818) 988-9305
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
G74901
CA
208600000X
Surgery Physician
Primary
G74901
CA
208D00000X
General Practice Physician
G74901
CA
Other
Enumeration date
09/19/2012
Last updated
09/19/2012
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