Organization
HAIR AESTHETIC INSTITUTE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH DAVID SIPORIN M.D., F.A.C.S. (PRESIDENT)
(310) 479-4247
Entity
Organization
Contact information
Practice address
11500 W OLYMPIC BLVD, SUITE 315, LOS ANGELES, CA 90064-1524
(310) 479-4247
(310) 479-4241
Mailing address
11500 W OLYMPIC BLVD, SUITE 315, LOS ANGELES, CA 90064-1524
(310) 479-4247
(310) 479-4241
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
G70646
CA
Other
Enumeration date
10/25/2012
Last updated
01/10/2013
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