# TEMECULA VALLEY ADVANCED WOUND CARE, MEDICAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396360152
- **Authorized official:** DR. ROBERT PAUL CARRILLO MD (PRESIDENT)
- **Authorized official phone:** (619) 995-3273

## Contact information

- **Practice address:** 27555 YNEZ RD STE 400, TEMECULA, CA 92591-4679
- **Practice address phone:** (951) 466-6764
- **Mailing address:** 11105 MEADOW GLEN WAY E, ESCONDIDO, CA 92026-7008
- **Mailing address phone:** (619) 995-3273

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 06/08/2020
- **Last updated:** 06/08/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1831149749 | NPPES | — |