Organization
MANE OF YOUR DREAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATSY GALLIAN (BILLING/CRENDENTIALING)
(214) 437-2272
Entity
Organization
Contact information
Practice address
11553 FOOTHILL BLVD STE 101, RANCHO CUCAMONGA, CA 91730-0731
(909) 969-1833
Mailing address
10210 BASELINE RD SPC 267, ALTA LOMA, CA 91701-6048
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
1744P3200X
Prosthetics Case Management
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
KK347413
COSMETOLOGY LICENSE
CA
Enumeration date
03/09/2020
Last updated
03/09/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us