Organization
EXCEPTIONAL WOUND CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER J NICIFOROS MD (CEO)
(323) 423-5519
Entity
Organization
Contact information
Practice address
818 N MOUNTAIN AVE STE 203H, UPLAND, CA 91786-4167
(840) 208-6474
Mailing address
818 N MOUNTAIN AVE STE 203H, UPLAND, CA 91786-4167
(840) 208-6474
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
Primary
—
—
Other
Enumeration date
08/25/2025
Last updated
10/20/2025
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