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General NPI Number Information
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NPI Number | 1982403424
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Entity Type | Organization
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Legal Business Name | APOLLO MEDICAL WOUND CARE LLC
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Dates
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Enumeration Date | 03/08/2025
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Last Update Date | 03/08/2025
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Provider Practice Location Address
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Address Line | 4161 OCEANSIDE BLVD STE 5
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City | OCEANSIDE
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State | CA
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Zip | 92056-6035
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Country | US
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Telephone | 858-648-7398
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Fax |
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Provider Business Mailing Address
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Address Line | 4161 OCEANSIDE BLVD STE 5
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City | OCEANSIDE
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State | CA
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Zip | 92056-6035
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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 | MANAGING MEMBER
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Name | HOMER TUAZON
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Credential | DNP
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Telephone | 702-417-3865
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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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