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Organization
GENESIS MEDSPA, INC
Active
Organization
GENESIS MEDSPA, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARGARITA LOZADA FERNANDEZ NURSE PRACTITIONER (SECRETARY)
(858) 254-3762
Entity
Organization
Contact information
Practice address
22323 SHERMAN WAY, SUITE # 19-20, CANOGA PARK, CA 91303-1002
(818) 884-8110
(805) 832-4301
Mailing address
1216 BAYSIDE CIR, OXNARD, CA 93035-2147
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A-26431
CA
Other
Enumeration date
04/04/2013
Last updated
04/04/2013
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