Provider Demographics
NPI:1689471260
Name:MULTISPECIALTY SURGICAL & WOUND CARE TRAVELING CONSULTANTS
Entity type:Organization
Organization Name:MULTISPECIALTY SURGICAL & WOUND CARE TRAVELING CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIDSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD PHD DBA ND
Authorized Official - Phone:310-212-1500
Mailing Address - Street 1:1270 S ALFRED ST # 1064
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-2506
Mailing Address - Country:US
Mailing Address - Phone:310-212-1500
Mailing Address - Fax:
Practice Address - Street 1:1425 W MANCHESTER AVE UNIT A1425
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90047-5439
Practice Address - Country:US
Practice Address - Phone:310-242-7400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-28
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty