Healthcare Provider Details

I. General information

NPI: 1922810415
Provider Name (Legal Business Name): WOUND CARE ANYWHERE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2025
Last Update Date: 05/09/2025
Certification Date: 05/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

871 CORONADO CENTER DR
HENDERSON NV
89052-3977
US

IV. Provider business mailing address

6620 RASHELDA CT
LAS VEGAS NV
89130-1257
US

V. Phone/Fax

Practice location:
  • Phone: 213-713-3164
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. MARIO ANTONIO PACADA
Title or Position: DIRECTOR
Credential:
Phone: 213-713-3164