Healthcare Provider Details

I. General information

NPI: 1184590598
Provider Name (Legal Business Name): PHX MOBILE WOUND CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2025
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 S HOPE ST APT 416
LOS ANGELES CA
90012-5018
US

IV. Provider business mailing address

121 S HOPE ST APT 416
LOS ANGELES CA
90012-5018
US

V. Phone/Fax

Practice location:
  • Phone: 602-851-1266
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ANDREW EPSTEIN
Title or Position: OWNER
Credential:
Phone: 602-851-1266