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General NPI Number Information
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NPI Number | 1013838911
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Entity Type | Organization
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Legal Business Name | PRESTIGIOUS MEDICAL AESTHETICS
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Dates
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Enumeration Date | 07/24/2026
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Last Update Date | 07/24/2026
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Provider Practice Location Address
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Address Line | 40820 WINCHESTER RD STE 2505
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City | TEMECULA
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State | CA
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Zip | 92591-5525
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Country | US
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Telephone | 951-764-5962
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Fax |
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Provider Business Mailing Address
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Address Line | 40820 WINCHESTER RD STE 2505
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City | TEMECULA
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State | CA
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Zip | 92591-5525
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Country | US
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Telephone | 951-764-5962
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SELEAINA A THOMAS
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Credential | DNP FNP
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Telephone | 951-764-5962
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number |
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License Number State |
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