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General NPI Number Information
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NPI Number | 1649568023
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Entity Type | Organization
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Legal Business Name | AESTHETIQUE LASER INSTITUTE, INC.
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Dates
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Enumeration Date | 07/19/2011
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Last Update Date | 05/05/2020
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Provider Practice Location Address
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Address Line | 8920 WILSHIRE BLVD STE 603
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-1970
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Country | US
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Telephone | 310-734-7333
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Fax |
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Provider Business Mailing Address
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Address Line | 8920 WILSHIRE BLVD STE 603
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-1970
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Country | US
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Telephone | 310-734-7333
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. SHARON MCBETH
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Credential | M.D.
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Telephone | 949-646-7336
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | A39618
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License Number State | CA
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