| Optimal Care Wound Management LLC | |
|
4959 Palo Verde St Ste 208c-5 Montclair CA 91763-2360 | |
| (626) 715-8678 | |
| Not Available |
| Full Name | Optimal Care Wound Management LLC |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 4959 Palo Verde St Ste 208c-5, Montclair, California |
| Authorized Official Name and Position | Helen Lamaria (OWNER) |
| Authorized Official Contact | 6267158678 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Optimal Care Wound Management LLC 4959 Palo Verde St Ste 208c-5 Montclair CA 91763-2360 | Optimal Care Wound Management LLC 4959 Palo Verde St Ste 208c-5 Montclair CA 91763-2360 Ph: (626) 715-8678 |
| NPI Number | 1255129342 |
|---|---|
| Provider Enumeration Date | 04/28/2025 |
| Last Update Date | 04/28/2025 |
| Certification Date | 04/28/2025 |
| Medicare PECOS PAC ID | 6709397391 |
|---|---|
| Medicare Enrollment ID | O20250619002250 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255129342 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Secondary |
| 363L00000X | Nurse Practitioner | () | Primary |
| Provider Name | Hani Benyamin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770783896 PECOS PAC ID: 7315951787 Enrollment ID: I20060206000711 |
| Provider Name | Dina Loyola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386304780 PECOS PAC ID: 9335632306 Enrollment ID: I20251208001628 |
| Provider Name | Raymond Balagtas Tinio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033751938 PECOS PAC ID: 0840765483 Enrollment ID: I20260424002941 |
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