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General NPI Number Information
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NPI Number | 1467357566
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Entity Type | Organization
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Legal Business Name | LUXE MEDICAL AESTHETICS
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Dates
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Enumeration Date | 10/09/2026
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Last Update Date | 10/09/2026
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Provider Practice Location Address
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Address Line | 33492 OAK GLEN RD STE I
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City | YUCAIPA
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State | CA
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Zip | 92399-2096
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Country | US
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Telephone | 909-801-0486
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Fax |
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Provider Business Mailing Address
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Address Line | 33492 OAK GLEN RD STE I
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City | YUCAIPA
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State | CA
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Zip | 92399-2096
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Country | US
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Telephone | 909-801-0486
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JOHN DESANTIS
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Credential | DO
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Telephone | 909-801-0486
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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 | NULL
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