# LAGUNA AESTHETICS & FAMILY WELLNESS CENTER, INC

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

## Provider details

- **NPI number:** 1881060135
- **Authorized official:** AMANDA MIYAWAKI (OFFICE MANAGER)
- **Authorized official phone:** (949) 632-8087

## Contact information

- **Practice address:** 1100 S COAST HWY, SUITE 212, LAGUNA BEACH, CA 92651-2968
- **Practice address phone:** (949) 632-8087
- **Practice address fax:** (949) 715-5889
- **Mailing address:** 1100 S COAST HWY, SUITE 212, LAGUNA BEACH, CA 92651-2968
- **Mailing address phone:** (949) 632-8087
- **Mailing address fax:** (949) 715-5889

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0505X | Adult Medicine Physician | — | NULL | Yes |
| 207QA0505X | Adult Medicine Physician | — | — | Yes |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |

## Other

- **Enumeration date:** 08/20/2015
- **Last updated:** 08/20/2015