Provider Demographics
NPI:1093692410
Name:ANTHEM WOUND CARE SERVICES INC
Entity type:Organization
Organization Name:ANTHEM WOUND CARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:SOLEDAD
Authorized Official - Middle Name:O
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-828-8400
Mailing Address - Street 1:6888 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90620-4107
Mailing Address - Country:US
Mailing Address - Phone:714-874-6023
Mailing Address - Fax:714-828-8424
Practice Address - Street 1:6888 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90620-4107
Practice Address - Country:US
Practice Address - Phone:714-874-6023
Practice Address - Fax:714-828-8424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty