Global Wound Care Medical Group | |
5901 W Century Blvd Ste 750 Los Angeles CA 90045-5443 | |
(323) 480-4075 | |
Not Available |
Full Name | Global Wound Care Medical Group |
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Speciality | General Practice |
Location | 5901 W Century Blvd Ste 750, Los Angeles, California |
Authorized Official Name and Position | Owen Bernardo Ellington (PRESIDENT) |
Authorized Official Contact | 7133044227 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Global Wound Care Medical Group 5901 W Century Blvd Ste 750 Los Angeles CA 90045-5443 Ph: (323) 480-4075 | Global Wound Care Medical Group 5901 W Century Blvd Ste 750 Los Angeles CA 90045-5443 Ph: (323) 480-4075 |
NPI Number | 1235831132 |
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Provider Enumeration Date | 03/22/2023 |
Last Update Date | 01/26/2024 |
Medicare PECOS PAC ID | 9335504539 |
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Medicare Enrollment ID | O20230421001839 |
Identifier | Type | State | Issuer |
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1235831132 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | (* (Not Available)) | Primary |
332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Secondary |
Provider Name | Tara A Abernathy |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1194066712 PECOS PAC ID: 0143444620 Enrollment ID: I20140624002220 |
Provider Name | Aldridge S Westrich |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1316457179 PECOS PAC ID: 9931461084 Enrollment ID: I20180821001463 |
Provider Name | Wesley Nahm |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1720009590 PECOS PAC ID: 7113906561 Enrollment ID: I20230124000650 |
Provider Name | Vanessa Pearson |
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Provider Type | Practitioner - Preventive Medicine |
Provider Identifiers | NPI Number: 1215241427 PECOS PAC ID: 1850634726 Enrollment ID: I20240214002496 |
Provider Name | Lacrista Venable |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1265991780 PECOS PAC ID: 3173950490 Enrollment ID: I20240605002303 |
Provider Name | Adeyinka Adebayo |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1952715294 PECOS PAC ID: 0749612752 Enrollment ID: I20240614001565 |
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