Healthcare Provider Details

I. General information

NPI: 1114269560
Provider Name (Legal Business Name): ESTHETIC EYES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2013
Last Update Date: 12/24/2020
Certification Date: 12/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9615 BRIGHTON WAY STE 313
BEVERLY HILLS CA
90210-5152
US

IV. Provider business mailing address

9615 BRIGHTON WAY STE 313
BEVERLY HILLS CA
90210-5152
US

V. Phone/Fax

Practice location:
  • Phone: 310-271-8801
  • Fax:
Mailing address:
  • Phone: 310-271-8801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number89227-13
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number89227-13
License Number StateCA

VIII. Authorized Official

Name: BELLA SHKOLNIK
Title or Position: BILLING MANAGER
Credential:
Phone: 310-367-4695