| Central Wound Care Inc | |
|
6356 Van Nuys Blvd Ste 211 Van Nuys CA 91401-2741 | |
| (747) 300-7389 | |
| Not Available |
| Full Name | Central Wound Care Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 6356 Van Nuys Blvd Ste 211, Van Nuys, California |
| Authorized Official Name and Position | Vahan Manukyan (CEO) |
| Authorized Official Contact | 8186464441 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Central Wound Care Inc 6356 Van Nuys Blvd Ste 211 Van Nuys CA 91401-2741 | Central Wound Care Inc 6356 Van Nuys Blvd Ste 211 Van Nuys CA 91401-2741 Ph: (747) 300-7389 |
| NPI Number | 1912791393 |
|---|---|
| Provider Enumeration Date | 04/08/2025 |
| Last Update Date | 04/11/2025 |
| Certification Date | 04/11/2025 |
| Medicare PECOS PAC ID | 4183137458 |
|---|---|
| Medicare Enrollment ID | O20250630003420 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912791393 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
| Provider Name | Kevin Foster |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1184851545 PECOS PAC ID: 8224382213 Enrollment ID: I20181109001277 |
| Provider Name | Samantha Camille De La Cruz Kasingsing |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477349363 PECOS PAC ID: 7517474695 Enrollment ID: I20250724003938 |
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