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General NPI Number Information
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NPI Number | 1922783331
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Entity Type | Organization
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Legal Business Name | BAD-BETTY LLC
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Dates
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Enumeration Date | 06/21/2023
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Last Update Date | 06/25/2023
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Provider Practice Location Address
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Address Line | 489 S ROBERTSON BLVD STE 105
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-3637
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Country | US
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Telephone | 424-379-1077
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Fax |
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Provider Business Mailing Address
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Address Line | 4627 DON ZAREMBO DR
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City | LOS ANGELES
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State | CA
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Zip | 90008-4122
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Country | US
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Telephone | 323-823-1245
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Fax |
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Authorized Official
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Title or Position | ELECTROLOGIST
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Name | CHIZOBA UDEORJI
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Credential | CCE
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Telephone | 424-379-1077
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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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