Organization
MOBILE WOUND CARE & MULTI-SPECIALTY MEDICAL GROUP
Active
Organization
MOBILE WOUND CARE & MULTI-SPECIALTY MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL SHANE DAVIDSON MD (CEO)
(310) 212-1500
Entity
Organization
Contact information
Practice address
1425 W MANCHESTER AVE STE A, LOS ANGELES, CA 90047-5436
(626) 869-6050
Mailing address
1270 S ALFRED ST UNIT 1064, LOS ANGELES, CA 90035-2506
(310) 212-1500
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
04/29/2024
Last updated
04/29/2024
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