Healthcare Provider Details

I. General information

NPI: 1063242261
Provider Name (Legal Business Name): CAT & MOUSE ELECTROLYSIS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2024
Last Update Date: 08/30/2024
Certification Date: 08/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 W CALIFORNIA BLVD STE 228
PASADENA CA
91105-3033
US

IV. Provider business mailing address

159 N MARENGO AVE APT 102
PASADENA CA
91101-4505
US

V. Phone/Fax

Practice location:
  • Phone: 909-206-2443
  • Fax:
Mailing address:
  • Phone: 909-206-2443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State

VIII. Authorized Official

Name: DIANA NOEL
Title or Position: CEO
Credential: ELECTROLOGIST
Phone: 909-243-1996