Healthcare Provider Details

I. General information

NPI: 1841181344
Provider Name (Legal Business Name): PACIFIC WOUND INSTITUTE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2025
Last Update Date: 10/01/2025
Certification Date: 10/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 GEORGIA ST STE 303
VALLEJO CA
94590-5993
US

IV. Provider business mailing address

301 GEORGIA ST STE 303
VALLEJO CA
94590-5993
US

V. Phone/Fax

Practice location:
  • Phone: 707-431-0441
  • Fax:
Mailing address:
  • Phone: 707-431-0441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: GARRETT ECKERLING
Title or Position: CEO
Credential: MD
Phone: 760-296-7562