Supportive Wound Care, Inc

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

SUPPORTIVE WOUND CARE, INC

Practice address

1202 Monte Vista Ave Ste 6
Upland, CA 91786-8209

Phone

(310) 435-7575

NPI assigned

Mar 22, 2024

Organization subpart

No

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

Authorized official

Name

Lior Matian

Title

Ceo

Phone

(310) 435-7575

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 4

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

• Maximo Christian Diamond, M.D.

  • Internal Medicine Physician
  • Orange, CA
  • NPI 1063519932
  Medicare reassignment Care Compare group NPD
• Yousef W Ireifej, M.D.

  • Family Medicine Physician
  • Garden Grove, CA
  • NPI 1962693598
  Medicare reassignment Care Compare group NPD
• Tamara Sue Pippin, FNP

  • Family Nurse Practitioner
  • San Jacinto, CA
  • NPI 1508569567
  Medicare reassignment NPD
• Yusleydys Panade Roman, NP

  • Family Nurse Practitioner
  • Upland, CA
  • NPI 1003652579
  NPD

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

{
    "created_epoch": "1711065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711065600000",
    "number": "1891545083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 MONTE VISTA AVE STE 6",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917868209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 MONTE VISTA AVE STE 6",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917868209",
            "telephone_number": "310-435-7575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPPORTIVE WOUND CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-22",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A",
        "authorized_official_last_name": "MATIAN",
        "authorized_official_first_name": "LIOR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-435-7575"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sunrise Home Care,Inc.
• Sunset Haven
• Superior Health Care Providers, Inc.
• Superior Home Health Care Services Inc
• Supportive Home Health, Inc.
• Suraj Rasania MD Inc
• Surjit K. Kahlon, M.D., Professional Corp.
• Susan Biegel MD Inc
• Swamidass and Goodacre Dental Corp
• Min Swe, DDS

• Clinic/Center in Upland, CA
• Providers in Upland, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 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.