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General NPI Number Information
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NPI Number | 1578441242
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Entity Type | Organization
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Legal Business Name | PRIME WOUND SOLUTIONS INC
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Dates
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Enumeration Date | 08/21/2025
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 1421 E COOLEY DR STE 9
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City | COLTON
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State | CA
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Zip | 92324-3979
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Country | US
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Telephone | 909-377-1171
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Fax |
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Provider Business Mailing Address
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Address Line | 1421 E COOLEY DR STE 9
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City | COLTON
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State | CA
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Zip | 92324-3979
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JEMAR LINSANGAN
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Credential |
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Telephone | 909-377-1171
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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