Healthcare Provider Details

I. General information

NPI: 1205747524
Provider Name (Legal Business Name): MIAS BEAUTY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14815 S WESTERN AVE
GARDENA CA
90249-3309
US

IV. Provider business mailing address

2581 W 120TH ST 210 SUITE E
HAWTHORNE CA
90250
US

V. Phone/Fax

Practice location:
  • Phone: 213-948-9995
  • Fax:
Mailing address:
  • Phone: 323-777-8388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: TAMIA NIQHI LYONS
Title or Position: CRANIAL PROSTHESIS SPECIALIST
Credential:
Phone: 213-948-9995