Provider Demographics
NPI:1528065216
Name:WOODING, LENORE GRETCHEN (MD)
Entity type:Individual
Prefix:
First Name:LENORE
Middle Name:GRETCHEN
Last Name:WOODING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:254 COHASSET RD
Mailing Address - Street 2:STE 10
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-2210
Mailing Address - Country:US
Mailing Address - Phone:530-893-9244
Mailing Address - Fax:
Practice Address - Street 1:254 COHASSET RD
Practice Address - Street 2:STE 10
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2210
Practice Address - Country:US
Practice Address - Phone:530-893-9244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG36360207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG36360Medicaid
A46659Medicare UPIN
CAG36360Medicaid