Provider Demographics
NPI:1144376468
Name:WOODRING, PATRICK HAROLD (OD)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:HAROLD
Last Name:WOODRING
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1621 SOLANO AVE
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94707-2108
Mailing Address - Country:US
Mailing Address - Phone:510-526-3937
Mailing Address - Fax:510-526-6133
Practice Address - Street 1:1621 SOLANO AVE
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94707-2108
Practice Address - Country:US
Practice Address - Phone:510-526-3937
Practice Address - Fax:510-526-6133
Is Sole Proprietor?:No
Enumeration Date:2007-01-27
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT6841152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT10425Medicare UPIN
CASD0068410Medicare PIN