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General NPI Number Information
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NPI Number | 1609618818
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Entity Type | Organization
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Legal Business Name | GRANDCARE WOUND SPECIALISTS
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Dates
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Enumeration Date | 06/10/2024
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Last Update Date | 06/10/2024
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Provider Practice Location Address
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Address Line | 3452 E FOOTHILL BLVD STE 130
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City | PASADENA
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State | CA
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Zip | 91107-6006
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Country | US
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Telephone | 866-554-2447
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Fax |
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Provider Business Mailing Address
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Address Line | 3452 E FOOTHILL BLVD STE 130
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City | PASADENA
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State | CA
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Zip | 91107-6006
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Country | US
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Telephone | 866-554-2447
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Fax |
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Authorized Official
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Title or Position | VP OF OPERATIONS
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Name | ARSINEH MEGHERDICH
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Credential |
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Telephone | 818-244-8446
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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