| Mdwound Llc | |
|
12828 10th St Chino CA 91710-4255 | |
| (702) 540-8097 | |
| Not Available |
| Full Name | Mdwound Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 12828 10th St, Chino, California |
| Authorized Official Name and Position | Jhoette Dumlao (OWNER) |
| Authorized Official Contact | 7025408097 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mdwound Llc 12828 10th St Chino CA 91710-4255 Ph: () - | Mdwound Llc 12828 10th St Chino CA 91710-4255 Ph: (702) 540-8097 |
| NPI Number | 1558173302 |
|---|---|
| Provider Enumeration Date | 01/20/2025 |
| Last Update Date | 01/20/2025 |
| Medicare PECOS PAC ID | 1153850912 |
|---|---|
| Medicare Enrollment ID | O20250123000294 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558173302 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jhoette A Dumlao |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104110105 PECOS PAC ID: 9537382965 Enrollment ID: I20161128002395 |
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