Healthcare Provider Details

I. General information

NPI: 1083340558
Provider Name (Legal Business Name): WOUND MANAGEMENT INSTITUTE, APMC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2022
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3390 UNIVERSITY AVE STE 640
RIVERSIDE CA
92501-3314
US

IV. Provider business mailing address

32158 CAMINO CAPISTRANO # A267
SAN JUAN CAPISTRANO CA
92675-3720
US

V. Phone/Fax

Practice location:
  • Phone: 909-226-2332
  • Fax: 909-370-4405
Mailing address:
  • Phone: 909-226-2332
  • Fax: 909-370-4405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. A J ROGERS
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 951-744-4158