Organization Active NPI

Skintegrity Wound Care

  • Family Medicine Physician
  • Carson, CA
National Provider Identifier
1427932938
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SKINTEGRITY WOUND CARE
Practice address
17919 Mackeson CT
Carson, CA 90746-1629
Phone
(310) 644-8302
NPI assigned
Aug 5, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2025

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

Authorized official

Name
Henry Pekun
Title
Cfo
Phone
(310) 877-5368

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

17919 Mackeson CT
Carson, CA 90746-1629

Mailing address

17919 Mackeson CT
Carson, CA 90746-1629
Phone (310) 644-8302

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251110002053 CA Part B Supplier - Clinic/Group Practice 4385134188 Receives reassigned benefits from 1 practitioner
Practice locations: Hawthorne, CA

National Provider Directory

National Provider Directory

Locations

13658 Hawthorne Blvd
Ste 200A
Hawthorne, CA 90250
Phone (310) 644-8302

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": "1754352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754352000000",
    "number": "1427932938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17919 MACKESON CT",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907461629",
            "telephone_number": "310-644-8302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17919 MACKESON CT",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907461629",
            "telephone_number": "310-644-8302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKINTEGRITY WOUND CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-05",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A",
        "authorized_official_last_name": "PEKUN",
        "authorized_official_first_name": "HENRY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "310-877-5368"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carson, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.