NPIMap

Organization Active NPI

Perpetual Wound Rescue

  • Internal Medicine Physician
  • Anaheim, CA
National Provider Identifier
1235921032
Registry record updated May 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PERPETUAL WOUND RESCUE
Practice address
1100 E Orangethorpe Ave Ste 200R
Anaheim, CA 92801-1144
Phone
(240) 808-0148
NPI assigned
May 19, 2025
Last updated
May 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2025

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

Authorized official

Name
Mikio Tachibana, MDNPI 1598721227
Title
Medical Director
Phone
(240) 808-0148

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 Physician 207R00000X Primary

Addresses

Primary practice location

1100 E Orangethorpe Ave Ste 200R
Anaheim, CA 92801-1144

Mailing address

1100 E Orangethorpe Ave Ste 200R
Anaheim, CA 92801-1144
Phone (240) 808-0148

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250829002150 CA Part B Supplier - Clinic/Group Practice 3274034350 Receives reassigned benefits from 13 practitioners
Practice locations: Anaheim, CA

National Provider Directory

National Provider Directory

Locations

1100 E Orangethorpe Ave
Ste 200R
Anaheim, CA 92801
Phone (714) 273-7672

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1747612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747612800000",
    "number": "1235921032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 E ORANGETHORPE AVE STE 200R",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928011144",
            "telephone_number": "240-808-0148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E ORANGETHORPE AVE STE 200R",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928011144",
            "telephone_number": "240-808-0148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERPETUAL WOUND RESCUE",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-19",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-19",
        "status": "A",
        "authorized_official_last_name": "TACHIBANA",
        "authorized_official_first_name": "MIKIO",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "240-808-0148",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.