=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871351379
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BEST HEALTHCARE WOUND SPECIALIST
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/08/2024
-----------------------------------------------------
Last Update Date | 03/08/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 517 E WILSON AVE STE 103A
-----------------------------------------------------
City | GLENDALE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91206-4376
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 213-868-3565
-----------------------------------------------------
Fax | 213-868-3565
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 517 E WILSON AVE STE 103A
-----------------------------------------------------
City | GLENDALE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91206-4376
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 213-868-3565
-----------------------------------------------------
Fax | 213-868-3565
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | MR. BENJAMIN A SABIO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 213-868-3565
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WW0000X
-----------------------------------------------------
Taxonomy Name | Wound Care Registered Nurse
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NULL
-----------------------------------------------------