Provider Demographics
NPI:1619702156
Name:WOUND CARE PROFESSIONALS
Entity type:Organization
Organization Name:WOUND CARE PROFESSIONALS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CYRIL
Authorized Official - Middle Name:
Authorized Official - Last Name:MACAPAGAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:657-366-1114
Mailing Address - Street 1:10 SHADY COVE CT
Mailing Address - Street 2:
Mailing Address - City:AZUSA
Mailing Address - State:CA
Mailing Address - Zip Code:91702-6258
Mailing Address - Country:US
Mailing Address - Phone:657-366-1114
Mailing Address - Fax:
Practice Address - Street 1:2461 E ORANGETHORPE AVE STE 227
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92831-5302
Practice Address - Country:US
Practice Address - Phone:657-366-1114
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty