Wound Physicians Of California Pc | |
23141 Verdugo Dr Ste 201 Laguna Hills CA 92653-1341 | |
(949) 215-5055 | |
(949) 326-5099 |
Full Name | Wound Physicians Of California Pc |
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Speciality | Family Medicine |
Location | 23141 Verdugo Dr Ste 201, Laguna Hills, California |
Authorized Official Name and Position | Reza Talebi Dolouei (OWNER) |
Authorized Official Contact | 6309628631 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Wound Physicians Of California Pc 23141 Verdugo Dr Ste 201 Laguna Hills CA 92653-1341 Ph: (949) 215-5055 | Wound Physicians Of California Pc 23141 Verdugo Dr Ste 201 Laguna Hills CA 92653-1341 Ph: (949) 215-5055 |
NPI Number | 1235916420 |
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Provider Enumeration Date | 09/11/2023 |
Last Update Date | 11/15/2023 |
Medicare PECOS PAC ID | 2264886704 |
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Medicare Enrollment ID | O20231002002559 |
Identifier | Type | State | Issuer |
---|---|---|---|
1235916420 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207QG0300X | Family Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
Provider Name | Pratibha Kayastha |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1942601281 PECOS PAC ID: 2769704527 Enrollment ID: I20141205000012 |
Provider Name | Reza Talebi Dolouei |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1639431836 PECOS PAC ID: 6507167053 Enrollment ID: I20160908001938 |
Provider Name | Akil Simon |
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Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1598100877 PECOS PAC ID: 6507121027 Enrollment ID: I20180601002298 |
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