Provider Demographics
NPI:1164035101
Name:TURLOCK WOUND CARE INC
Entity Type:Organization
Organization Name:TURLOCK WOUND CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HUY
Authorized Official - Middle Name:NGOC
Authorized Official - Last Name:DAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:209-656-0183
Mailing Address - Street 1:2150 COLORADO AVE
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95382-2003
Mailing Address - Country:US
Mailing Address - Phone:209-656-0183
Mailing Address - Fax:
Practice Address - Street 1:2150 COLORADO AVE
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382-2003
Practice Address - Country:US
Practice Address - Phone:209-656-0183
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-28
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No163WW0000XNursing Service ProvidersRegistered NurseWound CareGroup - Single Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty