Provider Demographics
NPI:1710778931
Name:SERENITY WOUND CARE INC
Entity type:Organization
Organization Name:SERENITY WOUND CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SMBAT
Authorized Official - Middle Name:
Authorized Official - Last Name:TOROSYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:424-464-4264
Mailing Address - Street 1:4110 HOLT BLVD
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:CA
Mailing Address - Zip Code:91763-4605
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4110 HOLT BLVD
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:CA
Practice Address - Zip Code:91763-4605
Practice Address - Country:US
Practice Address - Phone:424-464-4264
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center