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General NPI Number Information
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NPI Number | 1437942539
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Entity Type | Organization
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Legal Business Name | DIVINE TOUCH WOUND CARE INC
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Dates
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Enumeration Date | 05/22/2025
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 9333 BASE LINE RD STE 190
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-1300
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Country | US
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Telephone | 909-755-5166
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Fax | 909-755-5188
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Provider Business Mailing Address
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Address Line | 1200 S FIGUEROA ST APT E1007
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City | LOS ANGELES
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State | CA
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Zip | 90015-1392
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Country | US
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Telephone | 909-755-5166
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Fax | 909-755-5188
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Authorized Official
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Title or Position | OWNER
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Name | SHUJA AYOUBY
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Credential |
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Telephone | 909-755-5166
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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