MEDICARE: OPTIMUM WOUND CARE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician

General Provider Information

NPI Number	:	1578217451
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPTIMUM WOUND CARE INC

Provider Business Mailing Address
First Line	:	22151 VENTURA BLVD STE 101
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91364-1666
Country	:	US
Telephone Number	:	877-343-6885
Fax Number	:	877-343-9337

Provider Business Practice Location Address
First Line	:	22151 VENTURA BLVD STE 101
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91364-1666
Country	:	US
Telephone Number	:	877-343-6885
Fax Number	:	844-343-9337

Authorized Official
Title or Position	:	PRESIDENT & CEO
Name	:	SOHEILA DELRAHIM
Credential	:	MD
Telephone Number	:	877-343-6885

Provider Enumeration Date	:	02/09/2022
Last Update Date	:	12/10/2025

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