Provider Demographics
NPI:1639985401
Name:HLMG WOUND CARE INC
Entity type:Organization
Organization Name:HLMG WOUND CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIANNE
Authorized Official - Middle Name:CRYSTAL
Authorized Official - Last Name:GOBER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-906-4466
Mailing Address - Street 1:350 ARDEN AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-1110
Mailing Address - Country:US
Mailing Address - Phone:818-906-4466
Mailing Address - Fax:
Practice Address - Street 1:350 ARDEN AVE STE 101
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-1110
Practice Address - Country:US
Practice Address - Phone:818-906-4466
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-06
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty