Basic Information
| Provider Information | |||||||||
| NPI: | 1437422847 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | L&P MEDICAL AESTHETICS, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 105 ADDISON AVE | ||||||||
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| City: | PALO ALTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 943012401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6503273232 | ||||||||
| FaxNumber: | 6503271973 | ||||||||
| Practice Location | |||||||||
| Address1: | 105 ADDISON AVE | ||||||||
| Address2: | |||||||||
| City: | PALO ALTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 943012401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6503273232 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/15/2012 | ||||||||
| LastUpdateDate: | 09/15/2022 | ||||||||
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| AuthorizedOfficialLastName: | PARIKH | ||||||||
| AuthorizedOfficialFirstName: | SACHIN | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 6503273232 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 09/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207YS0123X | A96960 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Otolaryngology | Facial Plastic Surgery |
No ID Information.