Individual provider Active NPI

Marine Chilyan

  • Family Nurse Practitioner
  • North Hollywood, CA
National Provider Identifier
1639959661
Registry record updated Oct 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95027063 Issued in CA
Practice address
5260 Riverton Ave Apt 3
North Hollywood, CA 91601-3334
Phone
(818) 381-6777
NPI assigned
Oct 5, 2023
Last updated
Oct 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95027063 CA Primary

Addresses

Primary practice location

5260 Riverton Ave Apt 3
North Hollywood, CA 91601-3334

Mailing address

5260 Riverton Ave Apt 3
North Hollywood, CA 91601-3334
Phone (818) 381-6777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250718003359 CA Practitioner - Nurse Practitioner 4981110798 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wound Healing Care Specialists IncGroup PAC ID 5698019602, 9 clinicians

Practice addresses (Care Compare)

3536 Concours
Suite 225
Ontario, CA 91764-5585
Phone 90994404865585

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95027063CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wound Healing Care Specialists, Inc. CurrentSince Jul 1, 2025 Accepting new patients
Rancho Wound Care Center, PC CurrentSince Aug 21, 2025 Accepting new patients
Dermatology Collective Inc CurrentSince Jul 6, 2025 Accepting new patients

Locations

552 W Foothill Blvd
Ste 202
Glendora, CA 91741
Phone (626) 240-2020

3536 Concours
Ste 225
Ontario, CA 91764
Phone (314) 699-9181

10621 Church St
Ste 120
Rch Cucamonga, CA 91730
Phone (909) 944-0481

11343 Base Line Rd
Rch Cucamonga, CA 91730

25044 Peachland Ave
Ste 110
Santa Clarita, CA 91321

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1696464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1639959661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5260 RIVERTON AVE APT 3",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916013334",
            "telephone_number": "818-381-6777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5260 RIVERTON AVE APT 3",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916013334",
            "telephone_number": "818-381-6777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILYAN",
        "first_name": "MARINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-05",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95027063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Hollywood, CA

Sources for this page

Verify at the official NPI Registry.