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General NPI Number Information
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NPI Number | 1497553218
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Entity Type | Organization
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Legal Business Name | PANTHEON BODY CARE
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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 | 4713 1ST ST #252
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City | PLEASANTON
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State | CA
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Zip | 94566-7376
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Country | US
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Telephone | 415-494-9468
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Fax |
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Provider Business Mailing Address
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Address Line | 1146 SONATA DR
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City | VALLEJO
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State | CA
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Zip | 94591-3876
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Country | US
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Telephone | 415-494-9468
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Fax |
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Authorized Official
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Title or Position | LICENSED ELECTROLOGIST , OWNER
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Name | ARTEMIS FOX
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Credential | L.E.
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Telephone | 415-494-9468
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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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