Healthcare Provider Details

I. General information

NPI: 1689515496
Provider Name (Legal Business Name): THE MEDSPA AT BEVERLY HILLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2026
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 WILSHIRE BLVD STE 1110
LOS ANGELES CA
90048-5812
US

IV. Provider business mailing address

6200 WILSHIRE BLVD STE 1110
LOS ANGELES CA
90048-5812
US

V. Phone/Fax

Practice location:
  • Phone: 424-355-0116
  • Fax: 310-388-0732
Mailing address:
  • Phone: 424-355-0116
  • Fax: 310-388-0732

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: CRISTIANO BONETI
Title or Position: OWNER
Credential: MD
Phone: 305-699-9095