Provider Demographics
NPI:1578326013
Name:WOUND DOC, LLC
Entity Type:Organization
Organization Name:WOUND DOC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EJAZ
Authorized Official - Middle Name:
Authorized Official - Last Name:KAMBOJ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-726-9722
Mailing Address - Street 1:1770 N BUFFALO DR STE 113
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-2678
Mailing Address - Country:US
Mailing Address - Phone:702-650-0009
Mailing Address - Fax:702-906-0067
Practice Address - Street 1:1770 N BUFFALO DR STE 113
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-2678
Practice Address - Country:US
Practice Address - Phone:702-650-0009
Practice Address - Fax:702-906-0067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-06
Last Update Date:2024-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty