# VIVIDERM WOUND CARE

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

## Provider details

- **NPI number:** 1407654189
- **Authorized official:** DR. SOPHIA P HO DO (MEDICAL DIRECTOR)
- **Authorized official phone:** (714) 417-4452

## Contact information

- **Practice address:** 4081 POMELO DR, CORONA, CA 92883-3697
- **Practice address phone:** (714) 417-4452
- **Mailing address:** 4081 POMELO DR, CORONA, CA 92883-3697
- **Mailing address phone:** (714) 417-4452

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 03/06/2025
- **Last updated:** 04/20/2025