Organization
FACIALSPA INC.
Active
Other names
Project Health
Organization subpart
No
Provider details
NPI number
Authorized official
ADRIENNE D KENLAN RN (MEDICAL DIRECTOR)
(760) 722-3939
Entity
Organization
Contact information
Practice address
314 WISCONSIN AVE STE C, OCEANSIDE, CA 92054-4157
(760) 722-3939
(760) 722-0718
Mailing address
314 WISCONSIN AVE STE C, OCEANSIDE, CA 92054-4157
(760) 722-3939
(760) 722-0718
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
100858
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DME00776F
—
CA
Enumeration date
01/12/2007
Last updated
08/22/2020
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