Pacific Wound Center Medical Group, Inc.
LBN: Pacific Wound Center Medical Group, Inc.
Pacific Wound Center Medical Group, Inc. is an health care organization with primary practice located at 4722 Quail Lakes Dr Suite A, Stockton CA 95207-5256. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Cardiovascular Disease, Podiatric Medicine & Surgery Service Providers / Podiatrist. Allopathic & Osteopathic Physicians / Cardiovascular Disease is the primary health care specialty.
Pacific Wound Center Medical Group, Inc. can be contacted via phone (209) 476-0675, or through Mcdonald, William D. via phone (209) 476-0675.
Contact Information
Primary practice address
4722 Quail Lakes Dr Suite A
Stockton CA 95207-5256
Phone: (209) 476-0675
Fax: (209) 476-9389
Website:
Authorized official contact:
Name: Mcdonald, William D. Doctor of Podiatric Medicine (DPM)
Phone: (209) 476-0675
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | G74876 | California |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | A31110 | California |
| Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | E3287 | California |
Profile Details
| NPI number | 1659399202 |
|---|---|
| LBN Legal business name | Pacific Wound Center Medical Group, Inc. |
| DBA Doing business as | |
| Authorized official | Mcdonald, William D. Doctor of Podiatric Medicine (DPM) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 18th, 2006 |
| Last updated | Nov 23rd, 2015 - about 10 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659399202 | NPPES |
| California | Other | ZZZ07794Z | BLUE SHIELD |
| California | Other | ZZZ07794Z | BLUE SHIELD |
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