Organization
BEHNAM EBRAHIMI MD INC
Active
Parent organization
BEHNAM EBRAHIMI MD INC
Other names
Advanced Wound Therapy Inc
Organization subpart
Yes
Provider details
NPI number
Legal business name
BEHNAM EBRAHIMI MD INC
Authorized official
DR. BEHNAM EBRAHIMI MD (CEO)
(909) 630-7342
Entity
Organization
Contact information
Practice address
12577 NAPLES WAY, RANCHO CUCAMONGA, CA 91739-2631
(909) 365-9563
Mailing address
12577 NAPLES WAY, RANCHO CUCAMONGA, CA 91739-2631
(909) 365-9563
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
207RX0202X
Medical Oncology Physician
Primary
—
—
Other
Enumeration date
10/22/2025
Last updated
10/22/2025
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