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General NPI Number Information
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NPI Number | 1740113646
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Entity Type | Organization
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Legal Business Name | PREMIER MOBILE WOUND CARE NURSING.INC
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Dates
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Enumeration Date | 06/08/2026
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Last Update Date | 06/08/2026
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Provider Practice Location Address
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Address Line | 5535 CANOGA AVE APT 303
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City | WOODLAND HILLS
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State | CA
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Zip | 91367-6636
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Country | US
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Telephone | 310-460-8895
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Fax |
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Provider Business Mailing Address
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Address Line | 5535 CANOGA AVE APT 303 #303
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City | WOODLAND HILLS
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State | CA
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Zip | 91367-6636
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Country | US
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Telephone | 310-460-8895
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MAHTA SHARAFI
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Credential | NP
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Telephone | 310-460-8895
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number |
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License Number State |
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