Provider Demographics
NPI:1033919741
Name:MEND WISE
Entity type:Organization
Organization Name:MEND WISE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:MATEVOSYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-774-3818
Mailing Address - Street 1:5250 LANKERSHIM BLVD STE 500
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91601-3187
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5250 LANKERSHIM BLVD STE 500
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91601-3187
Practice Address - Country:US
Practice Address - Phone:747-774-3818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-13
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty