Provider Demographics
NPI:1851501977
Name:WOODRUFF, DAVID K (AUD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:K
Last Name:WOODRUFF
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 524
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA FE
Mailing Address - State:CA
Mailing Address - Zip Code:92067-0524
Mailing Address - Country:US
Mailing Address - Phone:858-759-8922
Mailing Address - Fax:858-759-8022
Practice Address - Street 1:6037 LA GRANADA
Practice Address - Street 2:SUITE D
Practice Address - City:RANCHO SANTA FE
Practice Address - State:CA
Practice Address - Zip Code:92067-0524
Practice Address - Country:US
Practice Address - Phone:858-759-8922
Practice Address - Fax:858-759-8022
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU1111, HA2516237600000X
CAAU1111237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAU001111Medicaid
CAAU0011110Medicaid
CAAU001111Medicaid
CAAUD1111Medicare PIN
CAR13905Medicare UPIN