Organization Active NPI

Biorestore Wound Care Inc.

  • Internal Medicine Physician
  • Rosemead, CA
National Provider Identifier
1154110633
Registry record updated May 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
BIORESTORE WOUND CARE INC.
Practice address
2421 San Gabriel Blvd
Rosemead, CA 91770-3653
Phone
(626) 741-5411
Fax
(626) 741-5412
NPI assigned
May 2, 2025
Last updated
May 2, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2025

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

Authorized official

Name
Dr. Kelvin Chen, MDNPI 1225387137
Title
Owner
Phone
(626) 741-5411

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

2421 San Gabriel Blvd
Rosemead, CA 91770-3653

Mailing address

2421 San Gabriel Blvd
Rosemead, CA 91770-3653
Phone (626) 741-5411

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250618001090 CA Part B Supplier - Clinic/Group Practice 2769993534 Receives reassigned benefits from 1 practitioner
Practice locations: Rosemead, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1746144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746144000000",
    "number": "1154110633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2421 SAN GABRIEL BLVD",
            "city": "ROSEMEAD",
            "state": "CA",
            "postal_code": "917703653",
            "telephone_number": "626-741-5411",
            "fax_number": "626-741-5412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2421 SAN GABRIEL BLVD",
            "city": "ROSEMEAD",
            "state": "CA",
            "postal_code": "917703653",
            "telephone_number": "626-741-5411",
            "fax_number": "626-741-5412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIORESTORE WOUND CARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-02",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-01",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "KELVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "626-741-5411",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosemead, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 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.