Provider Demographics
NPI:1285476408
Name:FIRST CLASS WOUND CARE CORP
Entity type:Organization
Organization Name:FIRST CLASS WOUND CARE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CYDNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:PURIFICACION
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-726-7774
Mailing Address - Street 1:10900 183RD ST STE 171-Q
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-5342
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10900 183RD ST STE 171-Q
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-5342
Practice Address - Country:US
Practice Address - Phone:562-319-5032
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-10
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty