MEDICARE: BEAUTY THROUGH BALANCE ND INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QH0100X	Health Service Clinic/Center	402	CA

General Provider Information

NPI Number	:	1447591003
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEAUTY THROUGH BALANCE ND INC

Provider Business Mailing Address
First Line	:	PO BOX 6185
Second Line	:
City	:	MALIBU
State	:	CA
Zip	:	90264-6185
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2709 GREENFIELD AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90064-4031
Country	:	US
Telephone Number	:	323-810-2831
Fax Number	:

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. MELANIE MCLEOD
Credential	:
Telephone Number	:	323-810-2831

Provider Enumeration Date	:	03/07/2013
Last Update Date	:	03/07/2013

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