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General NPI Number Information
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NPI Number | 1356149025
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Entity Type | Organization
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Legal Business Name | SKINSATIONAL AESTHETICS INC
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Dates
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Enumeration Date | 03/06/2025
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Last Update Date | 03/06/2025
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Provider Practice Location Address
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Address Line | 350 TERRACINA BLVD
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City | REDLANDS
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State | CA
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Zip | 92373-4850
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Country | US
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Telephone | 818-709-8161
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Fax | 818-709-8160
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Provider Business Mailing Address
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Address Line | PO BOX 9126
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City | CANOGA PARK
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State | CA
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Zip | 91309-0126
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Country | US
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Telephone | 818-709-8161
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Fax | 818-709-8160
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Authorized Official
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Title or Position | OWNER, CEO, CFO
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Name | SAMEH MIKHAIL
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Credential | MD
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Telephone | 562-355-1918
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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