Healthcare Provider Details

I. General information

NPI: 1356204044
Provider Name (Legal Business Name): WOUND SMART HEALTH GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12011 VICTORY BLVD STE 201
NORTH HOLLYWOOD CA
91606-3330
US

IV. Provider business mailing address

12011 VICTORY BLVD STE 201
NORTH HOLLYWOOD CA
91606-3330
US

V. Phone/Fax

Practice location:
  • Phone: 818-424-2224
  • Fax:
Mailing address:
  • Phone: 818-424-2224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: MRS. NARE PETROSYAN
Title or Position: PRESIDENT
Credential:
Phone: 818-424-2224