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General NPI Number Information
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NPI Number | 1891674446
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Entity Type | Organization
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Legal Business Name | PREMIER WOUND MANAGEMENT
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Dates
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Enumeration Date | 08/28/2025
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 401 N BRAND BLVD STE L103E
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City | GLENDALE
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State | CA
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Zip | 91203-4459
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Country | US
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Telephone | 818-730-5352
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Fax |
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Provider Business Mailing Address
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Address Line | 401 N BRAND BLVD STE L103E
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City | GLENDALE
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State | CA
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Zip | 91203-4459
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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 | CEO
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Name | VILIK HARUTUNYAN
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Credential | REGISTERED NURSE
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Telephone | 818-730-5352
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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 | NULL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State | NULL
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