| Premier Wound Care Of Los Angeles | |
|
711 W College St Ste 188 Los Angeles CA 90012-1093 | |
| (213) 261-0889 | |
| (213) 261-0889 |
| Full Name | Premier Wound Care Of Los Angeles |
|---|---|
| Speciality | Internal Medicine |
| Location | 711 W College St Ste 188, Los Angeles, California |
| Authorized Official Name and Position | Shuo Steven Wang (CEO, MD) |
| Authorized Official Contact | 2132610889 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Wound Care Of Los Angeles 315 Wisteria Way Sierra Madre CA 91024-1137 Ph: (626) 679-5118 | Premier Wound Care Of Los Angeles 711 W College St Ste 188 Los Angeles CA 90012-1093 Ph: (213) 261-0889 |
| NPI Number | 1366956690 |
|---|---|
| Provider Enumeration Date | 11/22/2017 |
| Last Update Date | 11/22/2017 |
| Medicare PECOS PAC ID | 6002176088 |
|---|---|
| Medicare Enrollment ID | O20180213000724 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366956690 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Shuo Wang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538232137 PECOS PAC ID: 3375645435 Enrollment ID: I20070221000284 |
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