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Organization
TEMECULA VALLEY ADVANCED WOUND CARE, MEDICAL CORPORATION
Active
Organization
TEMECULA VALLEY ADVANCED WOUND CARE, MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT PAUL CARRILLO MD (PRESIDENT)
(619) 995-3273
Entity
Organization
Contact information
Practice address
27555 YNEZ RD STE 400, TEMECULA, CA 92591-4679
(951) 466-6764
Mailing address
11105 MEADOW GLEN WAY E, ESCONDIDO, CA 92026-7008
(619) 995-3273
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1831149749
NPPES
—
Enumeration date
06/08/2020
Last updated
06/08/2020
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