Organization
SOUTH BAY REGENERATIVE MEDICAL SPA INC
Active
Other names
Body Care Regenerative Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE VILLA (BILLING DEPT)
(805) 474-9053
Entity
Organization
Contact information
Practice address
412 S PACIFIC COAST HWY STE 100, REDONDO BEACH, CA 90277-3712
(310) 792-9100
(310) 792-1180
Mailing address
412 S PACIFIC COAST HWY STE 100, REDONDO BEACH, CA 90277-3712
(310) 792-9100
(310) 792-1180
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
05/28/2020
Last updated
05/28/2020
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