Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | MD448503 | PA |
N | 208600000X | Surgeon | MD448503 | PA |
Y | 2086X0206X | Surgical Oncologist | A122229 | CA |
NPI | 1306000757 |
---|---|
Provider Name | Dr. Amanda Michael Woodworth |
First Address | Los Angeles, CA 90031-0309 |
Second Address | Los Angeles, CA 90033-5331 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2008 |
Last Update Date | 07/02/2022 |