| American Wound Care PC | |
|
14349 Victory Blvd Ste 200 Van Nuys CA 91401-6515 | |
| (917) 732-6379 | |
| Not Available |
| Full Name | American Wound Care PC |
|---|---|
| Speciality | Internal Medicine |
| Location | 14349 Victory Blvd Ste 200, Van Nuys, California |
| Authorized Official Name and Position | Oren Raphael (OWNER) |
| Authorized Official Contact | 9177326379 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| American Wound Care PC 14349 Victory Blvd Ste 200 Van Nuys CA 91401-6515 | American Wound Care PC 14349 Victory Blvd Ste 200 Van Nuys CA 91401-6515 Ph: (917) 732-6379 |
| NPI Number | 1881417889 |
|---|---|
| Provider Enumeration Date | 11/06/2024 |
| Last Update Date | 11/06/2024 |
| Certification Date | 11/06/2024 |
| Medicare PECOS PAC ID | 8729514054 |
|---|---|
| Medicare Enrollment ID | O20241210004806 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881417889 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| 207RH0002X | Internal Medicine - Hospice And Palliative Medicine | () | Secondary |
| Provider Name | Oren Simantov Raphael |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255726485 PECOS PAC ID: 8123405198 Enrollment ID: I20220512000748 |
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