Organization
TOTAL BODY AESTHETIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KINDRA ROSS LICENSED RN (OWNER)
(209) 207-4980
Entity
Organization
Contact information
Practice address
1525 MESA VERDE DR E STE 214, COSTA MESA, CA 92626-5219
(833) 665-2639
Mailing address
1525 MESA VERDE DR E STE 214, COSTA MESA, CA 92626-5219
(562) 881-8459
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
—
Other
Enumeration date
04/11/2019
Last updated
04/11/2019
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