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General NPI Number Information
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NPI Number | 1093692410
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Entity Type | Organization
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Legal Business Name | ANTHEM WOUND CARE SERVICES INC
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Dates
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Enumeration Date | 08/18/2025
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 6888 LINCOLN AVE
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City | BUENA PARK
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State | CA
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Zip | 90620-4107
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Country | US
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Telephone | 714-874-6023
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Fax | 714-828-8424
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Provider Business Mailing Address
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Address Line | 6888 LINCOLN AVE
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City | BUENA PARK
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State | CA
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Zip | 90620-4107
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Country | US
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Telephone | 714-874-6023
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Fax | 714-828-8424
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | SOLEDAD O LEE
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Credential | MD
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Telephone | 714-828-8400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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