Wound Care Center of Socal PC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

WOUND CARE CENTER OF SOCAL PC

Practice address

984 W Foothill Blvd Ste a
Upland, CA 91786-3700

Phone

(909) 920-0884

Fax

(909) 920-9810

NPI assigned

Jan 23, 2025

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Roberta Lee

Title

Biller

Phone

(323) 543-4303

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jason Homan, DPM

  • Foot & Ankle Surgery Podiatrist
  • San Jose, CA
  • NPI 1285064824
  Medicare reassignment NPD
• Dhaval I Patel, D.P.M

  • Foot & Ankle Surgery Podiatrist
  • Upland, CA
  • NPI 1508152851
  Medicare reassignment NPD
• Adam Shapiro

  • Primary Podiatric Medicine Podiatrist
  • Upland, CA
  • NPI 1669854089

  Foot & Ankle Surgery

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1737590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738281600000",
    "number": "1083426274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "984 W FOOTHILL BLVD STE A",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917863700",
            "telephone_number": "909-920-0884",
            "fax_number": "909-920-9810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "984 W FOOTHILL BLVD STE A",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917863700",
            "telephone_number": "909-920-0884",
            "fax_number": "909-920-9810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOUND CARE CENTER OF SOCAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-23",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "ROBERTA",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "323-543-4303"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristy Marie Woodward
• Amanda Mae Woolery, CD(DONA)
• Kimberly Workman
• Cindy Lynne Worland, RADT1
• Kellishia T Worsham
• Wound Wellness Center
• Samuel Denny Wright
• Yu Sheng Wu, M.D.
• Georg Yachoa
• Jiehui Yan, OMD

• Foot & Ankle Surgery Podiatrist in Upland, CA
• Providers in Upland, CA by specialty
• Foot & Ankle Surgery Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.