Organization Active NPI

Dermavex Wound Care

  • General Practice Physician
  • Glendale, CA
National Provider Identifier
1497666408
Registry record updated Sep 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
DERMAVEX WOUND CARE
Practice address
620 N Brand Blvd Ste 609
Glendale, CA 91203-4208
Phone
(310) 734-9046
NPI assigned
Sep 16, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2026

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

Authorized official

Name
Khusravshoh Majidov
Title
Ceo/Owner
Phone
(310) 734-9046

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

620 N Brand Blvd Ste 609
Glendale, CA 91203-4208

Mailing address

620 N Brand Blvd Ste 609
Glendale, CA 91203-4208
Phone (310) 734-9046

NPI Registry JSON

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

{
    "created_epoch": "1789516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789516800000",
    "number": "1497666408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 N BRAND BLVD STE 609",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912034208",
            "telephone_number": "310-734-9046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 N BRAND BLVD STE 609",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912034208",
            "telephone_number": "310-734-9046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMAVEX WOUND CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-16",
        "last_updated": "2026-09-16",
        "certification_date": "2026-09-16",
        "status": "A",
        "authorized_official_last_name": "MAJIDOV",
        "authorized_official_first_name": "KHUSRAVSHOH",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "310-734-9046"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.