Healthcare Provider Details

I. General information

NPI: 1780408963
Provider Name (Legal Business Name): XPRESS WOUND CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2024
Last Update Date: 11/13/2024
Certification Date: 11/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16430 VANOWEN ST UNIT B
VAN NUYS CA
91406-4729
US

IV. Provider business mailing address

16430 VANOWEN ST UNIT B
VAN NUYS CA
91406-4729
US

V. Phone/Fax

Practice location:
  • Phone: 714-790-0119
  • Fax:
Mailing address:
  • Phone: 714-790-0119
  • 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: MAHBAD ZARGAR
Title or Position: CEO
Credential:
Phone: 714-790-0119