# GLOWTOX AESTHETICS

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

## Provider details

- **NPI number:** 1346007168
- **Authorized official:** TIFFANY MARQUEZ-CARLES NP (SECRETARY)
- **Authorized official phone:** (707) 318-5424

## Contact information

- **Practice address:** 910 GRAND AVE STE 203-204, SAN DIEGO, CA 92109-4046
- **Practice address phone:** (707) 318-5424
- **Mailing address:** 1134 REED AVE, SAN DIEGO, CA 92109-5106

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 02/28/2024
- **Last updated:** 02/28/2024