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General NPI Number Information
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NPI Number | 1215687942
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Entity Type | Organization
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Legal Business Name | HOPE ELECTROLYSIS
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Dates
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Enumeration Date | 03/25/2022
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Last Update Date | 03/25/2022
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Provider Practice Location Address
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Address Line | 11633 SAN VICENTE BLVD STE 106
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City | LOS ANGELES
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State | CA
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Zip | 90049-6512
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Country | US
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Telephone | 626-714-9608
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Fax |
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Provider Business Mailing Address
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Address Line | 2624 LAKE AVE APT F
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City | ALTADENA
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State | CA
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Zip | 91001-1971
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Country | US
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Telephone | 626-714-9608
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Fax |
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Authorized Official
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Title or Position | ELECTROLIGIST
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Name | COURTNEY SYKES
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Credential | L9695
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Telephone | 626-714-9608
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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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