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General NPI Number Information
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NPI Number | 1538983069
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Entity Type | Organization
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Legal Business Name | ELECTROLYSIS HAIR REMOVAL LAB, LLC
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Dates
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Enumeration Date | 11/12/2024
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 12440 FIRESTONE BLVD STE 1027
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City | NORWALK
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State | CA
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Zip | 90650-4366
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Country | US
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Telephone | 562-256-5193
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Fax |
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Provider Business Mailing Address
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Address Line | 12440 FIRESTONE BLVD STE 1027
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City | NORWALK
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State | CA
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Zip | 90650-4366
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Country | US
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Telephone | 562-256-5193
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALICIA ANNETTE SANCHEZ
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Credential |
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Telephone | 562-256-5193
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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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