MEDICARE: WOUND DOCS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1578326013
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOUND DOCS, LLC

Provider Business Mailing Address
First Line	:	1770 N BUFFALO DR STE 113
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-2678
Country	:	US
Telephone Number	:	702-650-0009
Fax Number	:	702-906-0067

Provider Business Practice Location Address
First Line	:	1770 N BUFFALO DR STE 113
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-2678
Country	:	US
Telephone Number	:	702-650-0009
Fax Number	:	702-906-0067

Authorized Official
Title or Position	:	CEO
Name	:	EJAZ KAMBOJ
Credential	:	MD
Telephone Number	:	702-726-9722

Provider Enumeration Date	:	02/06/2024
Last Update Date	:	10/14/2024

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Directions to “WOUND DOCS, LLC ” Practice Location

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