Healthcare Provider Details

I. General information

NPI: 1699655167
Provider Name (Legal Business Name): ATG WOUND CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2025
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

473 E CARNEGIE DR SUITE 200
SAN BERNARDINO CA
92408
US

IV. Provider business mailing address

473 E CARNEGIE DR SUITE 200
SAN BERNARDINO CA
92408
US

V. Phone/Fax

Practice location:
  • Phone: 818-220-4222
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ARSEN TER GRIGORYAN
Title or Position: CEO
Credential:
Phone: 818-220-4222