MEDICARE: SNF WOUND CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1114393311
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SNF WOUND CARE

Provider Business Mailing Address
First Line	:	PO BOX 641519
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90064-6519
Country	:	US
Telephone Number	:	833-379-6863
Fax Number	:	833-379-6863

Provider Business Practice Location Address
First Line	:	11270 EXPOSITION BLVD FL 1
Second Line	:	BOX: 641519
City	:	LOS ANGELES
State	:	CA
Zip	:	90064-3255
Country	:	US
Telephone Number	:	833-379-6863
Fax Number	:	833-379-6863

Authorized Official
Title or Position	:	OWNER
Name	:	PAYAM M TEHRANI
Credential	:	MD
Telephone Number	:	833-379-6863

Provider Enumeration Date	:	08/11/2015
Last Update Date	:	01/02/2026

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Directions to “SNF WOUND CARE ” Practice Location

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