Healthcare Provider Details
I. General information
NPI: 1760316608
Provider Name (Legal Business Name): SAFEDERM WOUND SOLUTION INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
15760 VENTURA BLVD STE 700
ENCINO CA
91436-3016
US
IV. Provider business mailing address
15760 VENTURA BLVD STE 700
ENCINO CA
91436-3016
US
V. Phone/Fax
- Phone: 424-394-6353
- Fax:
- Phone: 424-394-6353
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
VLAD
PETCU
Title or Position: CEO/OWNER
Credential:
Phone: 424-394-6353