Healthcare Provider Details

I. General information

NPI: 1194614982
Provider Name (Legal Business Name): UVC-CLEAN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2025
Last Update Date: 08/17/2025
Certification Date: 08/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 E PACIFIC COAST HWY
LONG BEACH CA
90806-6218
US

IV. Provider business mailing address

9521 PACIFIC AVE
ANAHEIM CA
92804-5941
US

V. Phone/Fax

Practice location:
  • Phone: 562-218-1337
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SCOTT CROW
Title or Position: CELL REJUVENATION SPECIALIST
Credential:
Phone: 562-218-1337