Provider Demographics
NPI:1710470497
Name:ADVANCED WOUND CARE CONSULTANTS, INC
Entity Type:Organization
Organization Name:ADVANCED WOUND CARE CONSULTANTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:KULBIR
Authorized Official - Middle Name:
Authorized Official - Last Name:DHILLON
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:530-713-4306
Mailing Address - Street 1:124 CLAY ISLE CT
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95747-7183
Mailing Address - Country:US
Mailing Address - Phone:414-750-5373
Mailing Address - Fax:530-777-3472
Practice Address - Street 1:7807 UPLANDS WAY
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95610-7500
Practice Address - Country:US
Practice Address - Phone:414-750-5373
Practice Address - Fax:530-777-3472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-07
Last Update Date:2018-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA805034163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WW0000XNursing Service ProvidersRegistered NurseWound CareGroup - Single Specialty