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General NPI Number Information
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NPI Number | 1013731009
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Entity Type | Organization
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Legal Business Name | ADVANCED MOBILE WOUND CARE
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Dates
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Enumeration Date | 11/14/2024
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Last Update Date | 11/14/2024
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Provider Practice Location Address
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Address Line | 1021 E HARVARD RD
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City | BURBANK
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State | CA
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Zip | 91501-1329
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Country | US
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Telephone | 818-726-5686
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Fax |
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Provider Business Mailing Address
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Address Line | 1021 E HARVARD RD
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City | BURBANK
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State | CA
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Zip | 91501-1329
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MAGDEN MAGGIE AMIRIAN
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Credential |
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Telephone | 818-726-5686
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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