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General NPI Number Information
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NPI Number | 1821968843
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Entity Type | Organization
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Legal Business Name | NOVA WOUND CARE MEDICAL CORP
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Dates
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Enumeration Date | 11/05/2025
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 8500 WILSHIRE BLVD STE 1020
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-3108
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Country | US
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Telephone | 424-279-9610
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Fax | 310-360-6246
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Provider Business Mailing Address
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Address Line | 8500 WILSHIRE BLVD STE 1020
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-3108
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Country | US
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Telephone | 424-279-9610
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Fax | 310-360-6246
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Authorized Official
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Title or Position | PRACTICE OWNER
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Name | FARDAD FOROUZANPOUR
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Credential | DO
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Telephone | 424-279-9610
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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