| Global Wound Care Medical Group | |
|
5901 W Century Blvd Ste 750 Los Angeles CA 90045-5443 | |
| (323) 480-4075 | |
| Not Available |
| Full Name | Global Wound Care Medical Group |
|---|---|
| Speciality | General Practice |
| Location | 5901 W Century Blvd Ste 750, Los Angeles, California |
| Authorized Official Name and Position | Owen Bernardo Ellington (PRESIDENT) |
| Authorized Official Contact | 7133044227 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Global Wound Care Medical Group 5901 W Century Blvd Ste 750 Los Angeles CA 90045-5443 Ph: (323) 480-4075 | Global Wound Care Medical Group 5901 W Century Blvd Ste 750 Los Angeles CA 90045-5443 Ph: (323) 480-4075 |
| NPI Number | 1235831132 |
|---|---|
| Provider Enumeration Date | 03/22/2023 |
| Last Update Date | 01/26/2024 |
| Medicare PECOS PAC ID | 9335504539 |
|---|---|
| Medicare Enrollment ID | O20230421001839 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235831132 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Secondary |
| Provider Name | Tara A Abernathy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194066712 PECOS PAC ID: 0143444620 Enrollment ID: I20140624002220 |
| Provider Name | Aldridge S Westrich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316457179 PECOS PAC ID: 9931461084 Enrollment ID: I20180821001463 |
| Provider Name | Vanessa Pearson |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1215241427 PECOS PAC ID: 1850634726 Enrollment ID: I20240214002496 |
| Provider Name | Lacrista Venable |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265991780 PECOS PAC ID: 3173950490 Enrollment ID: I20240605002303 |
| Provider Name | Anna Ventura |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831896802 PECOS PAC ID: 3274905294 Enrollment ID: I20240610001159 |
| Provider Name | Adeyinka Adebayo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952715294 PECOS PAC ID: 0749612752 Enrollment ID: I20240614001565 |
| Provider Name | Yen Le Phan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174071799 PECOS PAC ID: 1355699810 Enrollment ID: I20240619000584 |
| Provider Name | Andrea Cronley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154819183 PECOS PAC ID: 8921342171 Enrollment ID: I20240719001638 |
| Provider Name | Celyn Iyoke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487268108 PECOS PAC ID: 2466865290 Enrollment ID: I20250303002963 |
| Provider Name | Amena Babers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184920894 PECOS PAC ID: 1951716653 Enrollment ID: I20250401001241 |
| Provider Name | Jacqueline Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093570483 PECOS PAC ID: 6103268123 Enrollment ID: I20250422000546 |
| Provider Name | Jasmain Macon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003699661 PECOS PAC ID: 5092156018 Enrollment ID: I20250611002524 |
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