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General NPI Number Information
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NPI Number | 1750172995
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Entity Type | Organization
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Legal Business Name | WOUND HAVEN INC
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Dates
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Enumeration Date | 05/15/2025
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Last Update Date | 05/15/2025
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Provider Practice Location Address
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Address Line | 2600 FOOTHILL BLVD STE 104
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City | LA CRESCENTA
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State | CA
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Zip | 91214-4578
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Country | US
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Telephone | 818-331-2685
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Fax |
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Provider Business Mailing Address
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Address Line | 2600 FOOTHILL BLVD STE 104
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City | LA CRESCENTA
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State | CA
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Zip | 91214-4578
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Country | US
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Telephone | 818-331-2685
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Fax |
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Authorized Official
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Title or Position | PRACTICE OWNER
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Name | HOVSEP ZEYTUNYAN
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Credential |
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Telephone | 818-331-2685
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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