| Phx Mobile Wound Care LLC | |
|
121 S Hope St Apt 416 Los Angeles CA 90012-5018 | |
| (602) 851-1266 | |
| Not Available |
| Full Name | Phx Mobile Wound Care LLC |
|---|---|
| Speciality | General Practice |
| Location | 121 S Hope St Apt 416, Los Angeles, California |
| Authorized Official Name and Position | Andrew Epstein (OWNER) |
| Authorized Official Contact | 6028511266 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Phx Mobile Wound Care LLC 121 S Hope St Apt 416 Los Angeles CA 90012-5018 | Phx Mobile Wound Care LLC 121 S Hope St Apt 416 Los Angeles CA 90012-5018 Ph: (602) 851-1266 |
| NPI Number | 1184590598 |
|---|---|
| Provider Enumeration Date | 10/13/2025 |
| Last Update Date | 10/13/2025 |
| Certification Date | 10/13/2025 |
| Medicare PECOS PAC ID | 3375038680 |
|---|---|
| Medicare Enrollment ID | O20251223002976 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184590598 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | () | Primary |
| 363L00000X | Nurse Practitioner | () | Secondary |
| Provider Name | Tamara S Pippin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508569567 PECOS PAC ID: 8628422532 Enrollment ID: I20231012000085 |
| Provider Name | Karissa Enojas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659150613 PECOS PAC ID: 2264880129 Enrollment ID: I20231204000258 |
| Provider Name | Andrew M Epstein |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1902141930 PECOS PAC ID: 2567771256 Enrollment ID: I20251031003538 |
| Provider Name | Josha Krista Ventura Hilahan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235905019 PECOS PAC ID: 9032604871 Enrollment ID: I20251219000933 |
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