| Wound Wellness Center | |
|
2345 W Foothill Blvd Ste 4 Upland CA 91786-3579 | |
| (310) 435-7575 | |
| Not Available |
| Full Name | Wound Wellness Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 2345 W Foothill Blvd Ste 4, Upland, California |
| Authorized Official Name and Position | Lior Matian (CEO) |
| Authorized Official Contact | 3104357575 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wound Wellness Center 2345 W Foothill Blvd Ste 4 Upland CA 91786-3579 | Wound Wellness Center 2345 W Foothill Blvd Ste 4 Upland CA 91786-3579 Ph: (310) 435-7575 |
| NPI Number | 1770382988 |
|---|---|
| Provider Enumeration Date | 03/10/2025 |
| Last Update Date | 03/10/2025 |
| Certification Date | 03/10/2025 |
| Medicare PECOS PAC ID | 3678074796 |
|---|---|
| Medicare Enrollment ID | O20250829003347 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770382988 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (NU) | Primary |
| Provider Name | Maximo Diamond |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063519932 PECOS PAC ID: 4082878699 Enrollment ID: I20120612000371 |
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