MEDICARE: ME MEDSPA & WELLNESS CLINIC, PROFESSIONAL CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	363LP2300X	Primary Care Nurse Practitioner
2	363LF0000X	Family Nurse Practitioner
3	2083P0901X	Public Health & General Preventive Medicine Physician
4	207QG0300X	Geriatric Medicine (Family Medicine) Physician
5	363LW0102X	Women's Health Nurse Practitioner
6	207QA0505X	Adult Medicine Physician

General Provider Information

NPI Number	:	1023991262
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ME MEDSPA & WELLNESS CLINIC, PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	24134 SUNNYMEAD BLVD STE A
Second Line	:
City	:	MORENO VALLEY
State	:	CA
Zip	:	92553-3096
Country	:	US
Telephone Number	:	818-459-2646
Fax Number	:

Provider Business Practice Location Address
First Line	:	24134 SUNNYMEAD BLVD
Second Line	:
City	:	MORENO VALLEY
State	:	CA
Zip	:	92553-3096
Country	:	US
Telephone Number	:	818-459-2646
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR-VICE PRESIDENT
Name	:	MS. MARILYN OYAN LAPAIX
Credential	:	NP
Telephone Number	:	818-459-2646

Provider Enumeration Date	:	07/28/2025
Last Update Date	:	02/18/2026

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