Organization Active NPI

Excell Wound Care Inc

  • General Practice Physician
  • Van Nuys, CA
National Provider Identifier
1194694380
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
EXCELL WOUND CARE INC
Practice address
6621 Van Nuys Blvd Ste 97
Van Nuys, CA 91405-4637
Phone
(818) 797-5030
NPI assigned
Nov 4, 2025
Last updated
Nov 4, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Gary Avanesov
Title
Owner
Phone
(818) 797-5030

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Wound Care Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WW0000X
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

6621 Van Nuys Blvd Ste 97
Van Nuys, CA 91405-4637

Mailing address

6621 Van Nuys Blvd Ste 97
Van Nuys, CA 91405-4637

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1762214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762214400000",
    "number": "1194694380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6621 VAN NUYS BLVD STE 97",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914054637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6621 VAN NUYS BLVD STE 97",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914054637",
            "telephone_number": "818-797-5030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELL WOUND CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-04",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A",
        "authorized_official_last_name": "AVANESOV",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-797-5030"
    },
    "taxonomies": [
        {
            "code": "163WW0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Wound Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.