Organization
UNIVERSAL WOUND MANAGEMENT, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. A J ROGERS MD (CEO)
(909) 226-2332
Entity
Organization
Contact information
Practice address
3140 RED HILL AVE STE 150, COSTA MESA, CA 92626-3440
(302) 200-9686
(909) 370-4405
Mailing address
1550 E WASHINGTON ST STE 101, COLTON, CA 92324-4624
(302) 200-9686
(909) 370-4405
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
208200000X
Plastic Surgery Physician
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5259844
CA SECRETARY OF STATE
CA
Enumeration date
03/03/2023
Last updated
04/14/2023
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