Organization Active NPI

Nova Wound Care Medical Corp

  • Surgery Physician
  • Beverly Hills, CA
National Provider Identifier
1821968843
Registry record updated Dec 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
NOVA WOUND CARE MEDICAL CORP
Practice address
8500 Wilshire Blvd Ste 1020
Beverly Hills, CA 90211-3108
Phone
(424) 279-9610
Fax
(310) 360-6246
NPI assigned
Nov 5, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2025

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

Authorized official

Name
Fardad Forouzanpour, DONPI 1477673598
Title
Practice Owner
Phone
(424) 279-9610

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 PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

8500 Wilshire Blvd Ste 1020
Beverly Hills, CA 90211-3108

Mailing address

8500 Wilshire Blvd Ste 1020
Beverly Hills, CA 90211-3108
Phone (424) 279-9610

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260109003457 CA Part B Supplier - Clinic/Group Practice 9739665621 Receives reassigned benefits from 1 practitioner
Practice locations: Beverly Hills, CA

National Provider Directory

National Provider Directory
Tax ID family
Nova Wound Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1762300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765497600000",
    "number": "1821968843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8500 WILSHIRE BLVD STE 1020",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902113108",
            "telephone_number": "424-279-9610",
            "fax_number": "310-360-6246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8500 WILSHIRE BLVD STE 1020",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902113108",
            "telephone_number": "424-279-9610",
            "fax_number": "310-360-6246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVA WOUND CARE MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-05",
        "last_updated": "2025-12-12",
        "certification_date": "2025-12-12",
        "status": "A",
        "authorized_official_last_name": "FOROUZANPOUR",
        "authorized_official_first_name": "FARDAD",
        "authorized_official_title_or_position": "PRACTICE OWNER",
        "authorized_official_telephone_number": "424-279-9610",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 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.