# LEJOLIE MEDICAL SPA

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

## Provider details

- **NPI number:** 1962836361
- **Authorized official:** DR. PARVANEH RAFAELOFF M.D, (MEDICAL DIRECTOR)
- **Authorized official phone:** (818) 501-1114

## Contact information

- **Practice address:** 13041 VENTURA BLVD, STUDIO CITY, CA 91604-2237
- **Practice address phone:** (818) 501-1114
- **Practice address fax:** (818) 501-1116
- **Mailing address:** 13041 VENTURA BLVD, STUDIO CITY, CA 91604-2237
- **Mailing address phone:** (818) 501-1114
- **Mailing address fax:** (818) 501-1116

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | A52350 | CA | Yes |

## Other

- **Enumeration date:** 08/21/2013
- **Last updated:** 08/21/2013