Provider Demographics
NPI:1205515756
Name:TOTAL WOUND CARE INC
Entity type:Organization
Organization Name:TOTAL WOUND CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KASHANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-779-9480
Mailing Address - Street 1:16133 VENTURA BLVD STE 415
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2429
Mailing Address - Country:US
Mailing Address - Phone:818-804-5177
Mailing Address - Fax:
Practice Address - Street 1:16133 VENTURA BLVD STE 415
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2429
Practice Address - Country:US
Practice Address - Phone:818-804-5177
Practice Address - Fax:818-239-4239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-12
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty