# AESTHETIC ARTISTRY SURGICAL AND MEDICAL CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124273685
- **Authorized official:** LISA BOWMAN (DELEGATED OFFICIAL)
- **Authorized official phone:** (208) 559-7417

## Contact information

- **Practice address:** 1841 IRON POINT RD, FOLSOM, CA 95630-8838
- **Practice address phone:** (916) 983-9895
- **Practice address fax:** (916) 983-9850
- **Mailing address:** 2220 E BIDWELL ST, FOLSOM, CA 95630-3546
- **Mailing address phone:** (916) 983-9895

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | A63302 | CA | Yes |

## Other

- **Enumeration date:** 11/25/2008
- **Last updated:** 06/16/2018