Wound Wizardz | |
1703 Termino Ave Ste 106 Long Beach CA 90804-2126 | |
(610) 505-9702 | |
Not Available |
Full Name | Wound Wizardz |
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Speciality | Surgery |
Location | 1703 Termino Ave Ste 106, Long Beach, California |
Authorized Official Name and Position | Kevin Jackson (CEO) |
Authorized Official Contact | 6105059702 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Wound Wizardz 25044 Peachland Ave Ste 110 Newhall CA 91321-5730 Ph: (844) 960-2673 | Wound Wizardz 1703 Termino Ave Ste 106 Long Beach CA 90804-2126 Ph: (610) 505-9702 |
NPI Number | 1629891676 |
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Provider Enumeration Date | 11/06/2024 |
Last Update Date | 11/17/2024 |
Medicare PECOS PAC ID | 2860928629 |
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Medicare Enrollment ID | O20241204001651 |
Identifier | Type | State | Issuer |
---|---|---|---|
1629891676 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
208600000X | Surgery | (* (Not Available)) | Primary |
Provider Name | Mahwash Hirmendi |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1073576765 PECOS PAC ID: 0648372904 Enrollment ID: I20070216000664 |
Provider Name | Michael S Tehrani |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1427320704 PECOS PAC ID: 6002031572 Enrollment ID: I20140626000844 |
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