Organization Active NPI

Outpatient Wound Solutions, Inc.

  • Family Medicine Physician
  • Vacaville, CA
National Provider Identifier
1194017426
Registry record updated Apr 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A10786 Issued in CA
Legal business name
OUTPATIENT WOUND SOLUTIONS, INC.
Practice address
607 Elmira Rd
Suite 165
Vacaville, CA 95687-4655
Phone
(707) 999-0242
NPI assigned
May 4, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2012

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

Authorized official

Name
Brian Thomas Michaluk, DONPI 1417195603
Title
Owner
Phone
(707) 999-0242

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 20A10786 CA Primary

Addresses

Primary practice location

607 Elmira Rd
Suite 165
Vacaville, CA 95687-4655

Mailing address

607 Elmira Rd
Suite 165
Vacaville, CA 95687-4655
Phone (707) 999-0242

Other identifiers 1

IdentifierTypeStateIssuer
7618939MedicaidCA

National Provider Directory

National Provider Directory

Locations

1044 Heartwood Ave
Vallejo, CA 94591
Phone (707) 551-4773

521 Lorel Way
Yuba City, CA 95991
Phone (216) 973-2202

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1304467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333584000000",
    "number": "1194017426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 ELMIRA RD",
            "address_2": "SUITE 165",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956874655",
            "telephone_number": "707-999-0242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 ELMIRA RD",
            "address_2": "SUITE 165",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956874655",
            "telephone_number": "707-999-0242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUTPATIENT WOUND SOLUTIONS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-04",
        "last_updated": "2012-04-05",
        "status": "A",
        "authorized_official_last_name": "MICHALUK",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "707-999-0242",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A10786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7618939",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vacaville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.