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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