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Organization
ADVANCE WOUND CARE PROS
Active
Organization
ADVANCE WOUND CARE PROS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEVORK EKIMYAN (MANAGER)
(818) 939-6289
Entity
Organization
Contact information
Practice address
6257 VAN NUYS BLVD STE A, VAN NUYS, CA 91401-2733
(818) 939-6289
Mailing address
6257 VAN NUYS BLVD STE A, VAN NUYS, CA 91401-2733
(818) 939-6289
Taxonomy
Speciality
Code
Description
License number
State
207QA0000X
Adolescent Medicine (Family Medicine) Physician
—
NULL
207QA0000X
Adolescent Medicine (Family Medicine) Physician
—
—
363LP2300X
Primary Care Nurse Practitioner
Primary
—
NULL
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/28/2025
Last updated
05/28/2025
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