Organization
FLAWLESS SKIN IV HYDRATION MED SPA
Active
Other names
Flawless Skin IV Hydration Med Spa
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDITH ELLIS DNP,MSN,CNL,RN (FOUNDER/CEO)
(323) 538-1110
Entity
Organization
Contact information
Practice address
25101 THE OLD RD, STEVENSON RANCH, CA 91381-2206
(323) 538-1110
Mailing address
25101 THE OLD RD, STEVENSON RANCH, CA 91381-2206
(323) 538-1110
Taxonomy
Speciality
Code
Description
License number
State
133VN1201X
Obesity and Weight Management Nutrition Registered Dietitian
—
—
171400000X
Health & Wellness Coach
—
—
251E00000X
Home Health Agency
—
—
251F00000X
Home Infusion Agency
—
—
251T00000X
PACE Provider Organization
—
—
261Q00000X
Clinic/Center
—
—
261QI0500X
Infusion Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
01/02/2024
Last updated
01/02/2024
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