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General NPI Number Information
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NPI Number | 1164282042
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Entity Type | Organization
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Legal Business Name | POWER PULSE ELECTROLOGY LLC
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Dates
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Enumeration Date | 03/19/2024
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Last Update Date | 03/20/2024
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Provider Practice Location Address
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Address Line | 10351 SANTA MONICA BLVD STE 100
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City | LOS ANGELES
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State | CA
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Zip | 90025-6935
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Country | US
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Telephone | 310-709-5649
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Fax |
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Provider Business Mailing Address
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Address Line | 1484 S BEVERLY DR APT 213
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City | LOS ANGELES
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State | CA
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Zip | 90035-3066
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/ELECTROLOGIST
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Name | IVY ALEJANDRA CESENA-SINJUR
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Credential | L.R.E
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Telephone | 310-709-5649
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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