MEDICARE: HOLLYWOOD WOUND TREATMENT 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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1952274805
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOLLYWOOD WOUND TREATMENT INC

Provider Business Mailing Address
First Line	:	1800 VINE ST STE 256F
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90028-5250
Country	:	US
Telephone Number	:	818-212-5257
Fax Number	:

Provider Business Practice Location Address
First Line	:	1800 VINE ST STE 256F
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90028-5250
Country	:	US
Telephone Number	:	818-212-5257
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	VERONIKA ELISEEVA
Credential	:
Telephone Number	:	818-212-5257

Provider Enumeration Date	:	09/26/2025
Last Update Date	:	02/11/2026

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Directions to “HOLLYWOOD WOUND TREATMENT INC ” Practice Location

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