Healthcare Provider Details

I. General information

NPI: 1427922392
Provider Name (Legal Business Name): HARBOR WOUND CARE P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2025
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 E COOLEY DR STE 200D
COLTON CA
92324-3951
US

IV. Provider business mailing address

1420 E COOLEY DR STE 200D
COLTON CA
92324-3951
US

V. Phone/Fax

Practice location:
  • Phone: 951-210-7260
  • Fax:
Mailing address:
  • Phone: 951-210-7260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: ANOUSHEH ASHOURI
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: MD
Phone: 818-480-1418