Healthcare Provider Details

I. General information

NPI: 1578484820
Provider Name (Legal Business Name): SMART WOUND CARE A CALIFORNIA MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 E HUNTINGTON DR STE 300
ARCADIA CA
91006-3775
US

IV. Provider business mailing address

440 E HUNTINGTON DR STE 300
ARCADIA CA
91006-3775
US

V. Phone/Fax

Practice location:
  • Phone: 404-513-7543
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: AMOS YI
Title or Position: PRACTICE OWNER
Credential:
Phone: 404-513-7543