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General NPI Number Information
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NPI Number | 1679498265
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Entity Type | Organization
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Legal Business Name | O'NEAL ELITE ELECTEOLYSIS AND SKIN
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Dates
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Enumeration Date | 08/12/2026
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Last Update Date | 08/12/2026
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Provider Practice Location Address
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Address Line | 10123 HAWTHORNE BLVD
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City | ENGLEWOOD
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State | CA
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Zip | 90304
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Country | US
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Telephone | 747-322-1965
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Fax |
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Provider Business Mailing Address
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Address Line | 578 WASHINGTON BLVD # 842
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City | MARINA DEL REY
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State | CA
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Zip | 90292-5421
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Country | US
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Telephone | 747-322-1965
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JESSE O'NEAL
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Credential |
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Telephone | 747-322-1965
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246Z00000X
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Taxonomy Name | Other Specialist/Technologist
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License Number |
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License Number State |
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