NPIMap

Organization Active NPI

Wound Doctors

  • Surgery Physician
  • Inglewood, CA
National Provider Identifier
1679293724
Registry record updated May 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
WOUND DOCTORS
Practice address
575 E Hardy St Ste 312
Inglewood, CA 90301-4050
Phone
(661) 630-4343
Fax
(661) 630-4344
NPI assigned
Aug 30, 2022
Last updated
May 3, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2023

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

Authorized official

Name
Mehran Sourehnissani, MDNPI 1992745285
Title
President & Ceo
Phone
(310) 889-5447

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary

Addresses

Primary practice location

575 E Hardy St Ste 312
Inglewood, CA 90301-4050

Mailing address

575 E Hardy St Ste 312
Inglewood, CA 90301-4050
Phone (661) 630-4343

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221017003225 CA Part B Supplier - Clinic/Group Practice 9032585088 Receives reassigned benefits from 9 practitioners
Practice locations: Inglewood, CA

National Provider Directory

National Provider Directory

Locations

575 E Hardy St
Ste 312
Inglewood, CA 90301
Phone (310) 590-2333

23548 Lyons Ave
Ste D
Newhall, CA 91321

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1661817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683072000000",
    "number": "1679293724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 E HARDY ST STE 312",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903014050",
            "telephone_number": "661-630-4343",
            "fax_number": "661-630-4344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 E HARDY ST STE 312",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903014050",
            "telephone_number": "661-630-4343",
            "fax_number": "661-630-4344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOUND DOCTORS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-30",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A",
        "authorized_official_last_name": "SOUREHNISSANI",
        "authorized_official_first_name": "MEHRAN",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "310-889-5447",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Inglewood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.