Healthcare Provider Details

I. General information

NPI: 1730909581
Provider Name (Legal Business Name): TENDER WOUND CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2024
Last Update Date: 11/19/2024
Certification Date: 11/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22801 VENTURA BLVD STE 211
WOODLAND HILLS CA
91364-1266
US

IV. Provider business mailing address

22801 VENTURA BLVD STE 211
WOODLAND HILLS CA
91364-1266
US

V. Phone/Fax

Practice location:
  • Phone: 818-907-7828
  • Fax: 818-907-6157
Mailing address:
  • Phone: 818-907-7828
  • Fax: 818-907-6157

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: SHARON HOLLANDER
Title or Position: OWNER
Credential:
Phone: 818-907-7828