Provider Demographics
NPI:1043563109
Name:ITINERANT BARBER AND BEAUTY
Entity Type:Organization
Organization Name:ITINERANT BARBER AND BEAUTY
Other - Org Name:A GENTLEMANS GENT MR. DREW SPANGLER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DREW
Authorized Official - Middle Name:
Authorized Official - Last Name:SPANGLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-388-5683
Mailing Address - Street 1:3355 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 1406-B
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-1837
Mailing Address - Country:US
Mailing Address - Phone:213-388-5683
Mailing Address - Fax:
Practice Address - Street 1:3355 WILSHIRE BLVD
Practice Address - Street 2:SUITE 1406-B
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-1837
Practice Address - Country:US
Practice Address - Phone:213-388-5683
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-25
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGroup - Single Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
No173C00000XOther Service ProvidersReflexologistGroup - Single Specialty
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherGroup - Single Specialty
No251E00000XAgenciesHome Health
No251V00000XAgenciesVoluntary or CharitableGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No347C00000XTransportation ServicesPrivate VehicleGroup - Single Specialty
No374700000XNursing Service Related ProvidersTechnicianGroup - Single Specialty
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Single Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty