Healthcare Provider Details

I. General information

NPI: 1497013098
Provider Name (Legal Business Name): ROCKSTAR BEAUTY, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2012
Last Update Date: 03/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

462 N LINDEN DR SUITE 234
BEVERLY HILLS CA
90212-2247
US

IV. Provider business mailing address

462 N LINDEN DR SUITE 234
BEVERLY HILLS CA
90212-2247
US

V. Phone/Fax

Practice location:
  • Phone: 310-276-2548
  • Fax: 310-997-2566
Mailing address:
  • Phone: 310-276-2548
  • Fax: 310-997-2566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License NumberA94061
License Number StateCA

VIII. Authorized Official

Name: DR. NAVANJUN SINGH GREWAL
Title or Position: OWNER
Credential: M.D.
Phone: 310-276-2548