MEDICARE: WOUND INSTITUTE OF AMERICA

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	213E00000X	Podiatrist		CA
2	208200000X	Plastic Surgery Physician

General Provider Information

NPI Number	:	1437505393
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOUND INSTITUTE OF AMERICA

Provider Business Mailing Address
First Line	:	9663 SANTA MONICA BLVD # 1151
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90210-4303
Country	:	US
Telephone Number	:	310-919-4179
Fax Number	:	877-239-0944

Provider Business Practice Location Address
First Line	:	250 N ROBERTSON BLVD STE 104A
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-1794
Country	:	US
Telephone Number	:	310-919-4179
Fax Number	:	877-239-0944

Authorized Official
Title or Position	:	COO
Name	:	NICOLE GARRETT
Credential	:
Telephone Number	:	310-919-4179

Provider Enumeration Date	:	05/10/2016
Last Update Date	:	03/27/2026

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Directions to “WOUND INSTITUTE OF AMERICA ” Practice Location

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