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General NPI Number Information
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NPI Number | 1376026815
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Entity Type | Organization
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Legal Business Name | PERFETTA MEDICAL SPA INC
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Dates
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Enumeration Date | 09/11/2018
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Last Update Date | 09/07/2025
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Provider Practice Location Address
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Address Line | 22015 MAIN ST STE B
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City | CARSON
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State | CA
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Zip | 90745-2942
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Country | US
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Telephone | 424-264-5859
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Fax | 888-444-9401
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Provider Business Mailing Address
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Address Line | 22015 MAIN ST STE B
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City | CARSON
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State | CA
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Zip | 90745-2942
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Country | US
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Telephone | 424-264-5859
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Fax | 888-444-9401
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Authorized Official
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Title or Position | CEO
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Name | DR. MARK N SAMONTE
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Credential | MD
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Telephone | 310-850-5630
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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