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General NPI Number Information
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NPI Number | 1194319517
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Entity Type | Organization
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Legal Business Name | IMAJ SKIN & WELLNESS CENTER LLC
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Dates
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Enumeration Date | 02/25/2021
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Last Update Date | 08/19/2025
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Provider Practice Location Address
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Address Line | 10161 PARK RUN DR STE 150
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City | LAS VEGAS
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State | NV
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Zip | 89145-8872
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Country | US
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Telephone | 408-833-3158
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Fax |
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Provider Business Mailing Address
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Address Line | 10161 PARK RUN DR STE 150
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City | LAS VEGAS
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State | NV
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Zip | 89145-8872
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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 | CEO
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Name | CHERRY M LEE
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Credential | NP
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Telephone | 702-782-8941
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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