Provider Demographics
NPI:1114393311
Name:SNF WOUND CARE
Entity Type:Organization
Organization Name:SNF WOUND CARE
Other - Org Name:PAYAM TEHRANI MD APC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:PAYAM
Authorized Official - Middle Name:M
Authorized Official - Last Name:TEHRANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:833-379-6863
Mailing Address - Street 1:PO BOX 641519
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-6519
Mailing Address - Country:US
Mailing Address - Phone:310-270-6181
Mailing Address - Fax:833-379-6863
Practice Address - Street 1:1244 BENEDICT CANYON DR
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-2728
Practice Address - Country:US
Practice Address - Phone:833-379-6863
Practice Address - Fax:833-379-6863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-11
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty