Organization Active NPI

First Class Wound Care Corp

  • Internal Medicine Physician
  • Cerritos, CA
National Provider Identifier
1285476408
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
FIRST CLASS WOUND CARE CORP
Practice address
10900 183Rd St Ste 171-Q
Cerritos, CA 90703-5342
Phone
(562) 319-5032
NPI assigned
Jun 10, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Authorized official

Name
Dr. Cydney PurificacionNPI 1750958419
Title
Physician
Phone
(714) 726-7774

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

10900 183Rd St Ste 171-Q
Cerritos, CA 90703-5342

Mailing address

10900 183Rd St Ste 171-Q
Cerritos, CA 90703-5342

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240722002792 CA Part B Supplier - Clinic/Group Practice 2264978667 Receives reassigned benefits from 2 practitioners
Practice locations: Cerritos, CA

National Provider Directory

National Provider Directory

Locations

10900 183rd St
Ste 171Q
Cerritos, CA 90703
Phone (562) 319-5032

Practitioners & affiliated clinicians

Practitioners 2

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": "1717977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721692800000",
    "number": "1285476408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10900 183RD ST STE 171-Q",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907035342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10900 183RD ST STE 171-Q",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907035342",
            "telephone_number": "562-319-5032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST CLASS WOUND CARE CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-10",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-12",
        "status": "A",
        "authorized_official_last_name": "PURIFICACION",
        "authorized_official_first_name": "CYDNEY",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "714-726-7774",
        "authorized_official_name_prefix": "Dr."
    },
    "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 Cerritos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; 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.