| Brian M. Woo, D.d.s., M.d., Inc. | |
|
290 North Wayte Lane Fresno CA 93701-1324 | |
| (559) 459-5120 | |
| Not Available |
| Full Name | Brian M. Woo, D.d.s., M.d., Inc. |
|---|---|
| Speciality | Oral & Maxillofacial Surgery |
| Location | 290 North Wayte Lane, Fresno, California |
| Authorized Official Name and Position | Brian Michael Woo (PRESIDENT/OWNER) |
| Authorized Official Contact | 5594595120 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brian M. Woo, D.d.s., M.d., Inc. 290 North Wayte Lane Fresno CA 93701-1324 Ph: (559) 459-5120 | Brian M. Woo, D.d.s., M.d., Inc. 290 North Wayte Lane Fresno CA 93701-1324 Ph: (559) 459-5120 |
| NPI Number | 1982838579 |
|---|---|
| Provider Enumeration Date | 05/11/2009 |
| Last Update Date | 03/07/2023 |
| Medicare PECOS PAC ID | 5092853689 |
|---|---|
| Medicare Enrollment ID | O20091119000476 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982838579 | NPI | - | NPPES |
| GA 1484 | Other | CA | GENERAL ANESTHESIA LICENSE |
| A107428 | Other | CA | MEDICAL LICENSE |
| 50017 | Other | CA | DENTAL LICENSE |
| Provider Name | Brian M Woo |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1558579144 PECOS PAC ID: 8022156611 Enrollment ID: I20091119000455 |
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