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General NPI Number Information
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NPI Number | 1033065289
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Entity Type | Organization
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Legal Business Name | AVANTI PLUS MEDICAL SPA INC
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Dates
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Enumeration Date | 03/09/2026
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Last Update Date | 03/09/2026
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Provider Practice Location Address
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Address Line | 19267 COLIMA RD STE K
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City | ROWLAND HEIGHTS
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State | CA
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Zip | 91748-3007
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Country | US
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Telephone | 626-588-7851
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Fax |
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Provider Business Mailing Address
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Address Line | 19267 COLIMA RD STE K
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City | ROWLAND HEIGHTS
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State | CA
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Zip | 91748-3007
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Country | US
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Telephone | 626-588-7851
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Fax |
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Authorized Official
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Title or Position | NURSING DIRECTOR
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Name | MS. TERRA LEE
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Credential | RN
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Telephone | 760-880-5777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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