Mikia Aivaze
Individual provider Active NPI Wound Care Registered Nurse · Porter Ranch, CA
NPI 1508689779 · NPPES record last updated Nov 5, 2024
Key facts
- NPI
- 1508689779
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Wound Care Registered Nurse 163WW0000X
- License
- 00000000 (CA)
- Practice address
- 19331 Pine Valley Ave
Porter Ranch, CA 91326-1403 - Phone
- (818) 934-3463
- NPI assigned
- Nov 5, 2024
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00000000 | CA | MD | Foot & Ankle Surgery Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healpoint Mobile Wound Care, Inc. | Wound Care | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Wound Care Registered Nurse | 163WW0000X | 00000000 | CA | Yes |
Addresses
Primary practice location
19331 Pine Valley Ave
Porter Ranch, CA 91326-1403
Mailing address
19331 Pine Valley Ave
Porter Ranch, CA 91326-1403
Phone (818) 934-3463
Other providers in Porter Ranch, CA
- Ranjani Agrawal
- Shilpa Agrawal
- Nona Ahankoob
- Diana Aharonian
- Nara Han Ahn
- Shahrzad Akbary
- Juan M Alcantar
- Alicia Alcantara
- Adriana Alejandra Alejandre
- Aleksei Dolgov DDS Inc
All providers in Porter Ranch, CA · Wound Care Registered Nurse in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 5, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.