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Organization
LAGUNA AESTHETICS & FAMILY WELLNESS CENTER, INC
Active
Organization
LAGUNA AESTHETICS & FAMILY WELLNESS CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA MIYAWAKI (OFFICE MANAGER)
(949) 632-8087
Entity
Organization
Contact information
Practice address
1100 S COAST HWY, SUITE 212, LAGUNA BEACH, CA 92651-2968
(949) 632-8087
(949) 715-5889
Mailing address
1100 S COAST HWY, SUITE 212, LAGUNA BEACH, CA 92651-2968
(949) 632-8087
(949) 715-5889
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
—
NULL
207QA0505X
Adult Medicine Physician
Primary
—
—
208600000X
Surgery Physician
—
NULL
208600000X
Surgery Physician
—
—
Other
Enumeration date
08/20/2015
Last updated
08/20/2015
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