Provision Wound Care Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

PROVISION WOUND CARE INC

Practice address

15130 Ventura Blvd Ste 251
Sherman Oaks, CA 91403-3301

Phone

(310) 269-6644

NPI assigned

May 8, 2025

Organization subpart

No

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

Authorized official

Name

Susanna Babaian

Title

Ceo

Phone

(310) 269-6644

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mosen Michael Defrawy, MD

  • Internal Medicine Physician
  • Montebello, CA
  • NPI 1457409401
  Medicare reassignment

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

{
    "created_epoch": "1746662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746662400000",
    "number": "1760272124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15130 VENTURA BLVD STE 251",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914033301",
            "telephone_number": "310-269-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15130 VENTURA BLVD STE 251",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914033301",
            "telephone_number": "310-269-6644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVISION WOUND CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-08",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A",
        "authorized_official_last_name": "BABAIAN",
        "authorized_official_first_name": "SUSANNA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-269-6644"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Promed Home Health Care Inc
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• Providence Hospice Services, Inc
• Provision Wound Care Inc
• Psychological Healing Center
• Renita Jejuan Pullens, D.O.
• Pure Physical Therapy Services , PC
• Aubrey Pycior
• Qi Acupuncture & Herbs

• Internal Medicine Physician in Sherman Oaks, CA
• Providers in Sherman Oaks, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2025; 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.