| Valley Wound Healing Center, Inc. | |
|
4335 N Star Way A Modesto CA 95356-8624 | |
| (209) 342-5125 | |
| (209) 342-5128 |
| Full Name | Valley Wound Healing Center, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 4335 N Star Way, Modesto, California |
| Authorized Official Name and Position | Deborah Jane Babb (OWNER) |
| Authorized Official Contact | 2093425125 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Valley Wound Healing Center, Inc. 4335 N Star Way A Modesto CA 95356-8624 Ph: (209) 342-5125 | Valley Wound Healing Center, Inc. 4335 N Star Way A Modesto CA 95356-8624 Ph: (209) 342-5125 |
| NPI Number | 1730285073 |
|---|---|
| Provider Enumeration Date | 09/15/2006 |
| Last Update Date | 03/13/2023 |
| Medicare PECOS PAC ID | 2365541653 |
|---|---|
| Medicare Enrollment ID | O20070627000566 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730285073 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | David G Ellertson |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1912964495 PECOS PAC ID: 8325931454 Enrollment ID: I20040203001131 |
| Provider Name | Juan Lopez Solorza |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295747152 PECOS PAC ID: 6507947348 Enrollment ID: I20080117000411 |
| Provider Name | Stephen J Georgiou |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1851465256 PECOS PAC ID: 8224192422 Enrollment ID: I20090912000122 |
| Provider Name | Deborah Jane Babb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285904086 PECOS PAC ID: 8527167816 Enrollment ID: I20130620000277 |
| Provider Name | Benny L Wright |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1992894539 PECOS PAC ID: 4385631712 Enrollment ID: I20141024001513 |
| Provider Name | Karen L Fields |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942378583 PECOS PAC ID: 5597016642 Enrollment ID: I20180928001438 |
| Provider Name | Carol A Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033753504 PECOS PAC ID: 1254753619 Enrollment ID: I20200612001891 |
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