Individual
GRACE SHIRLEY WOODS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4910 DIRECTORS PL STE 350, SAN DIEGO, CA 92121-3834
(858) 571-9550
Mailing address
4910 DIRECTORS PL STE 350, SAN DIEGO, CA 92121-3834
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA55813
CA
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1151742
NON-MEDICARE
CA
Enumeration date
07/27/2018
Last updated
11/05/2023
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