| Profound Wound Specialists Inc | |
|
11145 Tampa Ave Ste 27a Porter Ranch CA 91326-2274 | |
| (818) 717-7181 | |
| Not Available |
| Full Name | Profound Wound Specialists Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 11145 Tampa Ave Ste 27a, Porter Ranch, California |
| Authorized Official Name and Position | Andranik Gevorkyan (CEO) |
| Authorized Official Contact | 3108859888 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Profound Wound Specialists Inc 11145 Tampa Ave Ste 27a Porter Ranch CA 91326-2274 Ph: (818) 717-7181 | Profound Wound Specialists Inc 11145 Tampa Ave Ste 27a Porter Ranch CA 91326-2274 Ph: (818) 717-7181 |
| NPI Number | 1063394716 |
|---|---|
| Provider Enumeration Date | 07/23/2025 |
| Last Update Date | 07/23/2025 |
| Certification Date | 07/23/2025 |
| Medicare PECOS PAC ID | 2062918782 |
|---|---|
| Medicare Enrollment ID | O20251001004185 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063394716 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (NU) | 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 |
Healpoint Mobile Wound Care, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 19331 Pine Valley Ave, Porter Ranch, CA 91326 Phone: 747-999-8939 |
Nana Barseghian Medical Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 11854 Eddleston Dr, Porter Ranch, CA 91326 Phone: 702-278-7851 |