Provider Demographics
NPI:1730198094
Name:BRUCE R. WOOD & SON INC.
Entity type:Organization
Organization Name:BRUCE R. WOOD & SON INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:925-933-5533
Mailing Address - Street 1:675 YGNACIO VALLEY RD
Mailing Address - Street 2:SUITE 106B
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-3860
Mailing Address - Country:US
Mailing Address - Phone:925-933-5533
Mailing Address - Fax:925-933-5031
Practice Address - Street 1:675 YGNACIO VALLEY RD
Practice Address - Street 2:SUITE 106B
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-3860
Practice Address - Country:US
Practice Address - Phone:925-933-5533
Practice Address - Fax:925-933-5031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASR Y CHB 21-600625332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0504910001Medicare NSC