| Miracle Mobile Wound Care | |
|
2450 Colorado Ave Ste 100e Santa Monica CA 90404-5535 | |
| (310) 453-1324 | |
| Not Available |
| Full Name | Miracle Mobile Wound Care |
|---|---|
| Speciality | Internal Medicine |
| Location | 2450 Colorado Ave Ste 100e, Santa Monica, California |
| Authorized Official Name and Position | Michael Toiserkani (OWNER) |
| Authorized Official Contact | 3104531324 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Miracle Mobile Wound Care 1322 S Barrington Ave Los Angeles CA 90025-1602 | Miracle Mobile Wound Care 2450 Colorado Ave Ste 100e Santa Monica CA 90404-5535 Ph: (310) 453-1324 |
| NPI Number | 1780569210 |
|---|---|
| Provider Enumeration Date | 08/06/2025 |
| Last Update Date | 08/06/2025 |
| Certification Date | 08/06/2025 |
| Medicare PECOS PAC ID | 7113429549 |
|---|---|
| Medicare Enrollment ID | O20250905001156 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780569210 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (NU) | Primary |
| Provider Name | Michael Toiserkani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477642502 PECOS PAC ID: 0648228437 Enrollment ID: I20050107000883 |
| Provider Name | Luke Jacob L Narciso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528874401 PECOS PAC ID: 4688102262 Enrollment ID: I20250109003212 |
| Provider Name | Sarah Lay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225848476 PECOS PAC ID: 7618497611 Enrollment ID: I20250220002747 |
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