# MODELE AESTHETICS AND MEDICAL SPA

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

## Provider details

- **NPI number:** 1801517362
- **Authorized official:** DR. TAREK MOQATTASH MD (PRESIDENT)
- **Authorized official phone:** (909) 353-8821

## Contact information

- **Practice address:** 8906 SAN BERNARDINO RD STE 130, RANCHO CUCAMONGA, CA 91730-8806
- **Practice address phone:** (909) 353-8821
- **Mailing address:** 8906 SAN BERNARDINO RD STE 130, RANCHO CUCAMONGA, CA 91730-8806
- **Mailing address phone:** (909) 353-8821

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 09/02/2022
- **Last updated:** 09/02/2022