| Advanced Wound Care & Hyperbaric Specialists, Pc | |
|
28078 Baxter Rd Suite 410 Murrieta CA 92563-1402 | |
| (951) 566-9800 | |
| (951) 566-9801 |
| Full Name | Advanced Wound Care & Hyperbaric Specialists, Pc |
|---|---|
| Speciality | Preventive Medicine |
| Location | 28078 Baxter Rd, Murrieta, California |
| Authorized Official Name and Position | Yoshinobu Mifune (PRESIDENT/CEO) |
| Authorized Official Contact | 6104421270 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Wound Care & Hyperbaric Specialists, Pc 28078 Baxter Rd Suite 410 Murrieta CA 92563-1402 Ph: (951) 566-9800 | Advanced Wound Care & Hyperbaric Specialists, Pc 28078 Baxter Rd Suite 410 Murrieta CA 92563-1402 Ph: (951) 566-9800 |
| NPI Number | 1902142987 |
|---|---|
| Provider Enumeration Date | 12/20/2012 |
| Last Update Date | 12/21/2012 |
| Medicare PECOS PAC ID | 9335393370 |
|---|---|
| Medicare Enrollment ID | O20130129000310 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902142987 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | C54792 (California) | Secondary |
| 2083P0011X | Preventive Medicine - Undersea And Hyperbaric Medicine | C54792 (California) | Primary |
| Provider Name | Yoshinobu Mifune |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902896525 PECOS PAC ID: 9830298181 Enrollment ID: I20120508000459 |
| Provider Name | Kristi Rene Favor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689707887 PECOS PAC ID: 5496903437 Enrollment ID: I20120917000119 |
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