Provider Demographics
NPI:1609752658
Name:WELLO WOUND CARE NURSING PC
Entity type:Organization
Organization Name:WELLO WOUND CARE NURSING PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:ROVIN
Authorized Official - Middle Name:APOSTOL
Authorized Official - Last Name:SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:224-425-1142
Mailing Address - Street 1:11413 ETIWANDA AVE
Mailing Address - Street 2:
Mailing Address - City:PORTER RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:91326-2013
Mailing Address - Country:US
Mailing Address - Phone:224-425-1142
Mailing Address - Fax:
Practice Address - Street 1:11239 VENTURA BLVD STE 212
Practice Address - Street 2:
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91604-3167
Practice Address - Country:US
Practice Address - Phone:084-443-5569
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty