Healthcare Provider Details

I. General information

NPI: 1437058708
Provider Name (Legal Business Name): ADVANCED WOUND CARE INSTITUTE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2026
Last Update Date: 11/03/2026
Certification Date: 11/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4234 RIVERWALK PKWY STE 120
RIVERSIDE CA
92505-3304
US

IV. Provider business mailing address

4234 RIVERWALK PKWY STE 120
RIVERSIDE CA
92505-3304
US

V. Phone/Fax

Practice location:
  • Phone: 951-773-4292
  • Fax:
Mailing address:
  • Phone: 951-773-4292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: PAULINA A MENDOZA-MANCINI
Title or Position: CEO
Credential: DO
Phone: 951-773-4293