MEDICARE: BEAUTY BEATS CANCER

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	335E00000X	Prosthetic/Orthotic Supplier

General Provider Information

NPI Number	:	1538887989
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEAUTY BEATS CANCER

Provider Business Mailing Address
First Line	:	15600 MULHOLLAND DR APT A
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90077-1519
Country	:	US
Telephone Number	:	415-238-7552
Fax Number	:

Provider Business Practice Location Address
First Line	:	5823 S 23RD WAY
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85040-3499
Country	:	US
Telephone Number	:	415-238-7552
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JON DESMOND HILL
Credential	:
Telephone Number	:	415-238-7552

Provider Enumeration Date	:	08/19/2022
Last Update Date	:	08/19/2022

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Directions to “BEAUTY BEATS CANCER ” Practice Location

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