ELITE WOUND SPECIALIST PC – NPI #1154148997
Clinic/Center

ELITE WOUND SPECIALIST PC is an AHC clinic located in VAN NUYS, CA. NPPES has assigned the NPI number 1154148997 to ELITE WOUND SPECIALIST PC on September 23, 2024. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QH0100X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Health Service

The NPI profile was last updated on Mar 19, 2026. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for ELITE WOUND SPECIALIST PC below.

NPI Profile for
ELITE WOUND SPECIALIST PC

NPI Number
1154148997
Enumeration Date

(about 2 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
ELITE WOUND SPECIALIST PC
Primary location
14553 DELANO ST STE 306
VAN NUYS, CA 91411-2858
Phone: (310) 621-9038 Fax:
Mailing address
325 N MAPLE DR
PO BOX 5772
BEVERLY HILLS, CA 90209-6002
Phone: (310) 621-9038 Fax:
Organization Subpart
No
Authorized Official
SHIMA PEZESHKI
SHAREHOLDER
Phone: (310) 500-9068
Updated
Certification Date
Mar 19, 2026

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QH0100X
- Clinic/Center / Health Service (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.