MEDICARE: THE VEIN LUXE ACADEMY LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	246RP1900X	Phlebotomy Technician

General Provider Information

NPI Number	:	1720934698
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE VEIN LUXE ACADEMY LLC

Provider Business Mailing Address
First Line	:	30375 SUMMERSIDE ST
Second Line	:
City	:	MURRIETA
State	:	CA
Zip	:	92563-6807
Country	:	US
Telephone Number	:	951-440-7001
Fax Number	:	951-440-7001

Provider Business Practice Location Address
First Line	:	30375 SUMMERSIDE ST
Second Line	:
City	:	MURRIETA
State	:	CA
Zip	:	92563-6807
Country	:	US
Telephone Number	:	951-440-7001
Fax Number	:

Authorized Official
Title or Position	:	LVN/OWNER
Name	:	MRS. JANICE LYNN CORBO
Credential	:	LVN
Telephone Number	:	951-440-7001

Provider Enumeration Date	:	03/04/2026
Last Update Date	:	06/20/2026

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