| Wound Genius | |
|
11716 Abbey Ln Porter Ranch CA 91326-2469 | |
| (314) 422-1432 | |
| Not Available |
| Full Name | Wound Genius |
|---|---|
| Speciality | Internal Medicine |
| Location | 11716 Abbey Ln, Porter Ranch, California |
| Authorized Official Name and Position | Paula O Spearman (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 9857783357 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wound Genius 11716 Abbey Ln Porter Ranch CA 91326-2469 Ph: (314) 422-1432 | Wound Genius 11716 Abbey Ln Porter Ranch CA 91326-2469 Ph: (314) 422-1432 |
| NPI Number | 1558184747 |
|---|---|
| Provider Enumeration Date | 11/05/2024 |
| Last Update Date | 08/14/2025 |
| Certification Date | 08/14/2025 |
| Medicare PECOS PAC ID | 2163959552 |
|---|---|
| Medicare Enrollment ID | O20241225000000 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558184747 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| 251E00000X | Home Health | () | Secondary |
| Provider Name | Aswin Nukala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093155350 PECOS PAC ID: 2466710637 Enrollment ID: I20171215001505 |
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