# HAIR AESTHETIC INSTITUTE INC

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

## Provider details

- **NPI number:** 1881947935
- **Authorized official:** KENNETH DAVID SIPORIN M.D., F.A.C.S. (PRESIDENT)
- **Authorized official phone:** (310) 479-4247

## Contact information

- **Practice address:** 11500 W OLYMPIC BLVD, SUITE 315, LOS ANGELES, CA 90064-1524
- **Practice address phone:** (310) 479-4247
- **Practice address fax:** (310) 479-4241
- **Mailing address:** 11500 W OLYMPIC BLVD, SUITE 315, LOS ANGELES, CA 90064-1524
- **Mailing address phone:** (310) 479-4247
- **Mailing address fax:** (310) 479-4241

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | G70646 | CA | Yes |

## Other

- **Enumeration date:** 10/25/2012
- **Last updated:** 01/10/2013