| Nexus Wound Consultants Pc | |
|
40 Lomada St Ladera Ladera Ranch CA 92694 | |
| (830) 285-8882 | |
| (830) 215-4711 |
| Full Name | Nexus Wound Consultants Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 40 Lomada St Ladera, Ladera Ranch, California |
| Authorized Official Name and Position | Samuel Jurca (OWNER) |
| Authorized Official Contact | 8302858882 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nexus Wound Consultants Pc Po Box 103804 Pasadena CA 91189-3804 Ph: (830) 285-8882 | Nexus Wound Consultants Pc 40 Lomada St Ladera Ladera Ranch CA 92694 Ph: (830) 285-8882 |
| NPI Number | 1225875313 |
|---|---|
| Provider Enumeration Date | 07/15/2024 |
| Last Update Date | 07/22/2024 |
| Medicare PECOS PAC ID | 2365974789 |
|---|---|
| Medicare Enrollment ID | O20241010000606 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225875313 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Latora Atrine Subani |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033649413 PECOS PAC ID: 4486902590 Enrollment ID: I20191108001717 |
| Provider Name | Harold Glenn Morales San Agustin |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1215272067 PECOS PAC ID: 3274802418 Enrollment ID: I20200107000821 |
| Provider Name | Tamara Sue Pippin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508569567 PECOS PAC ID: 8628422532 Enrollment ID: I20231012000085 |
| Provider Name | Stacey Raybuck |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720020076 PECOS PAC ID: 0941230858 Enrollment ID: I20241115002499 |
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