Individual
THOMAS ALLEN WOODBURY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
9089 BASELINE RD, SUITE 100, RANCHO CUCAMONGA, CA 91730-1295
(909) 941-9927
(909) 941-9027
Mailing address
9089 BASELINE RD, SUITE 100, RANCHO CUCAMONGA, CA 91730-1295
(909) 941-9927
(909) 941-9027
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
20A5929
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00AX59290
—
CA
Enumeration date
08/15/2005
Last updated
07/09/2007
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