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General NPI Number Information
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NPI Number | 1386538908
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Entity Type | Organization
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Legal Business Name | OMNI WOUND PHYSICIANS OR LLC
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Dates
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Enumeration Date | 06/06/2025
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Last Update Date | 11/10/2025
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Provider Practice Location Address
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Address Line | 1050 SW 6TH AVE STE 1100
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City | PORTLAND
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State | OR
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Zip | 97204-1153
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Country | US
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Telephone | 213-228-3538
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Fax |
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Provider Business Mailing Address
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Address Line | 25044 PEACHLAND AVE STE 110
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City | NEWHALL
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State | CA
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Zip | 91321-5730
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Country | US
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Telephone | 661-649-4713
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Fax |
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | OKEMEFUNA OKPARA
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Credential | MD
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Telephone | 213-228-3538
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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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