Organization
LEJOLIE MEDICAL SPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PARVANEH RAFAELOFF M.D, (MEDICAL DIRECTOR)
(818) 501-1114
Entity
Organization
Contact information
Practice address
13041 VENTURA BLVD, STUDIO CITY, CA 91604-2237
(818) 501-1114
(818) 501-1116
Mailing address
13041 VENTURA BLVD, STUDIO CITY, CA 91604-2237
(818) 501-1114
(818) 501-1116
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
A52350
CA
Other
Enumeration date
08/21/2013
Last updated
08/21/2013
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