Healthcare Provider Details

I. General information

NPI: 1275321788
Provider Name (Legal Business Name): LA HAIR CANDY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2025
Last Update Date: 04/26/2025
Certification Date: 04/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6088 ATLANTIC AVE STE B
LONG BEACH CA
90805-3000
US

IV. Provider business mailing address

6656 SPRINGVALE CT
EASTVALE CA
92880-3800
US

V. Phone/Fax

Practice location:
  • Phone: 562-283-3261
  • Fax:
Mailing address:
  • Phone: 562-233-7341
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. TINA OBAID
Title or Position: CEO
Credential:
Phone: 562-233-7341