Provider Demographics
NPI:1053186619
Name:BEYOND BEAUTY MEDICAL SPA INC
Entity type:Organization
Organization Name:BEYOND BEAUTY MEDICAL SPA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ESTELA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMACHO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-979-8895
Mailing Address - Street 1:4700 VON KARMAN AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2194
Mailing Address - Country:US
Mailing Address - Phone:949-203-3434
Mailing Address - Fax:
Practice Address - Street 1:4700 VON KARMAN AVE STE 102
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2194
Practice Address - Country:US
Practice Address - Phone:949-203-3434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-23
Last Update Date:2023-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty