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General NPI Number Information
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NPI Number | 1326408451
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Entity Type | Organization
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Legal Business Name | REJUVENATING SKIN CARE MEDICAL AESTHETICS
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Dates
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Enumeration Date | 03/02/2016
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Last Update Date | 03/02/2016
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Provider Practice Location Address
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Address Line | 709 W BEVERLY BLVD STE 202
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City | MONTEBELLO
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State | CA
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Zip | 90640-3600
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Country | US
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Telephone | 323-726-9692
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Fax |
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Provider Business Mailing Address
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Address Line | 709 W BEVERLY BLVD STE 202
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City | MONTEBELLO
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State | CA
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Zip | 90640-3600
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Country | US
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Telephone | 323-726-9692
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. DARLENE LYNDA SANCHEZ
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Credential |
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Telephone | 213-590-1632
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | NP16811
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License Number State | CA
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