Healthcare Provider Details

I. General information

NPI: 1144755141
Provider Name (Legal Business Name): UBERWOUNDCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2017
Last Update Date: 04/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2880 ZANKER RD SUITE 203
SAN JOSE CA
95134-2117
US

IV. Provider business mailing address

2880 ZANKER RD SUITE 203
SAN JOSE CA
95134-2117
US

V. Phone/Fax

Practice location:
  • Phone: 866-310-2314
  • Fax: 831-998-8423
Mailing address:
  • Phone: 866-310-2314
  • Fax: 831-998-8423

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code213EP0504X
TaxonomyPublic Medicine Podiatrist
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code332800000X
TaxonomyIndian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
License Number
License Number StateNULL
# 6
Primary TaxonomyN
Taxonomy Code335G00000X
TaxonomyMedical Foods Supplier
License Number
License Number StateNULL

VIII. Authorized Official

Name: PROF. BRET ALAN BARKER
Title or Position: CEO
Credential: RN, MSN, CCRN, PHN
Phone: 831-737-8275