Healthcare Provider Details

I. General information

NPI: 1053277731
Provider Name (Legal Business Name): MEDI MOBILE & WOUND CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2025
Last Update Date: 12/26/2025
Certification Date: 12/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29219 CANWOOD ST STE 240
AGOURA HILLS CA
91301-1590
US

IV. Provider business mailing address

29219 CANWOOD ST STE 240
AGOURA HILLS CA
91301-1590
US

V. Phone/Fax

Practice location:
  • Phone: 747-315-3813
  • Fax: 747-315-3823
Mailing address:
  • Phone: 747-315-3813
  • Fax: 747-315-3823

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: OVSANNA ARAKELYAN
Title or Position: PRESIDENT/CEO
Credential: FNP
Phone: 818-469-0066