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General NPI Number Information
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NPI Number | 1295534576
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Entity Type | Organization
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Legal Business Name | COLON HYDROTHERAPY & BEAUTY INC
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Dates
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Enumeration Date | 03/10/2025
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 213 W WILSON ST STE E
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City | COSTA MESA
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State | CA
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Zip | 92627-1667
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Country | US
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Telephone | 949-612-7508
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Fax |
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Provider Business Mailing Address
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Address Line | 213 W WILSON ST STE E
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City | COSTA MESA
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State | CA
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Zip | 92627-1667
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Country | US
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Telephone | 949-612-7508
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LI YOU
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Credential |
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Telephone | 949-612-7568
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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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