MEDICARE: PRO WOUND CARE INC

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	363L00000X	Nurse Practitioner

General Provider Information

NPI Number	:	1528911195
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRO WOUND CARE INC

Provider Business Mailing Address
First Line	:	200 W MILFORD ST # C328
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91203-5537
Country	:	US
Telephone Number	:	818-720-1981
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 W MILFORD ST # C328
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91203-5537
Country	:	US
Telephone Number	:	818-720-1981
Fax Number	:

Authorized Official
Title or Position	:	PRACTICE OWNER
Name	:	TINA BAGHOMIAN
Credential	:
Telephone Number	:	818-720-1981

Provider Enumeration Date	:	02/16/2026
Last Update Date	:	02/16/2026

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Directions to “PRO WOUND CARE INC ” Practice Location

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