MOBILE WOUND CARE PHYSICIAN ASSISTANT CORPORATION


Address: 2028 31st St, San Diego, CA 92104-5632
Phone: 8602270611

MOBILE WOUND CARE PHYSICIAN ASSISTANT CORPORATION (NPI# 1477932978) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1477932978
Entity Type Organization
Organization Name MOBILE WOUND CARE PHYSICIAN ASSISTANT CORPORATION
Other Organization Name MOBILE WOUND CARE
Practice Address 2028 31st St
San Diego
CA 92104-5632
Practice Telephone 8602270611
Mailing Telephone 8602270611
Enumeration Date 2015-05-29
Last Update Date 2015-05-29
Authorized Official Name NICHOLAS BAI (CEO)
Authorized Official Telephone 8602270611
Authorized Official Credential PA
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AS0400X Physician Assistant
Specialization: Surgical Technologist
52091 CA Physician Assistants & Advanced Practice Nursing Providers

Other Provider/Organization Names

Other Name Type Code
Mobile Wound Care Doing Business As Name - Organization

Office Location

Street Address 2028 31ST ST
City SAN DIEGO
State CA
Zip Code 92104-5632

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1164940789 Robert Brian Damone Acupuncturist 3370 29th Street, San Diego, CA 92104 2017-09-04
1780100636 Nicole Palacios Counselor 4170 Texas Street, Apt 1, San Diego, CA 92104 2017-08-22
1063938587 Indie C Oliver Landrum Case Manager/Care Coordinator 2220 Broadway, San Diego, CA 92104 2017-08-16
1669829008 Krystah Lynn Smith Doula 3370 Cherokee Ave, Unit 43, San Diego, CA 92104 2016-05-16
1063871853 Holly Nicole Hinderberger Dentist 2050 El Cajon Blvd, San Diego, CA 92104 2016-02-22
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Taxonomy Information

Taxonomy Code 363AS0400X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Surgical Technologist

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1437454220 Peter Deane Houston Physician Assistant 9040 Friars Rd Ste 230, San Diego, CA 92108-5860 2011-01-25
1720288087 Laura Ruth Duffy Physician Assistant 1643 6th Ave, #204, San Diego, CA 92101-2757 2007-07-24
1861539348 Norman K Moser Physician Assistant 34800 Bob Wilson Dr Suite 112, Nmcsd, San Diego, CA 92134-1112 2007-01-31
1538214515 Shaun D Young Physician Assistant 8901 Activity Road, San Diego, CA 92126 2007-01-23
1174612170 Jonathan Wu Physician Assistant 7525 Metropolitan Dr Ste 306, San Diego, CA 92108-4404 2006-10-11
1982798112 Virginia Ann Floco Physician Assistant 3030 Childrens Way Ste 402, San Diego, CA 92123-4228 2006-10-03
1366464471 Colleen Gustafson Espenschied Physician Assistant 2017 1st Ave, San Diego, CA 92101-2033 2006-07-25
1396719779 Brian Joseph O'neill Physician Assistant 11532 Village Ridge Rd, San Diego, CA 92131-3905 2006-02-14
1619974623 Kimberlee J Knox Physician Assistant 3307 4th Ave, San Diego, CA 92103-5703 2005-07-05
1073519278 James Harvey Kimber Physician Assistant 12547 El Camino Real, Unit E, San Diego, CA 92130-4054 2005-06-22
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Competitor

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City SAN DIEGO
Zip Code 92104

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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