Provider Demographics
NPI:1609129311
Name:CALIFORNIA WOUND HEALTH PC
Entity Type:Organization
Organization Name:CALIFORNIA WOUND HEALTH PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIEF MEDICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BORISON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-800-2799
Mailing Address - Street 1:5800 LANDERBROOK DRIVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MAYFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44124-6510
Mailing Address - Country:US
Mailing Address - Phone:323-800-2799
Mailing Address - Fax:440-461-1225
Practice Address - Street 1:400 S DETROIT ST
Practice Address - Street 2:SUITE 404
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-3527
Practice Address - Country:US
Practice Address - Phone:323-800-2799
Practice Address - Fax:440-461-1225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-18
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty