Organization Active NPI

Advtec Woundcare Inc

  • Family Medicine Physician
  • San Marcos, CA
National Provider Identifier
1538964572
Registry record updated Feb 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ADVTEC WOUNDCARE INC
Practice address
330 Rancheros Dr Ste 258
San Marcos, CA 92069-2979
Phone
(949) 324-8363
NPI assigned
Feb 14, 2025
Last updated
Feb 14, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2025

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

Authorized official

Name
Raquel Lacuesta
Title
Ceo
Phone
(949) 324-8363

Specialties & licenses 1

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

Addresses

Primary practice location

330 Rancheros Dr Ste 258
San Marcos, CA 92069-2979

Mailing address

330 Rancheros Dr Ste 258
San Marcos, CA 92069-2979

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250826004003 CA Part B Supplier - Clinic/Group Practice 6608394275 Receives reassigned benefits from 1 practitioner
Practice locations: Granada Hills, CA

National Provider Directory

National Provider Directory

Locations

10324 Balboa Blvd
Ste 225B
Granada Hills, CA 91344
Phone (424) 236-3049

330 Rancheros Dr
Ste 258
San Marcos, CA 92069
Phone (949) 324-8363

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": "1739491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739491200000",
    "number": "1538964572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 RANCHEROS DR STE 258",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920692979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 RANCHEROS DR STE 258",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920692979",
            "telephone_number": "949-324-8363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVTEC WOUNDCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-14",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A",
        "authorized_official_last_name": "LACUESTA",
        "authorized_official_first_name": "RAQUEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-324-8363"
    },
    "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 San Marcos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 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.