Provider Demographics
NPI:1164282042
Name:POWER PULSE ELECTROLOGY LLC
Entity Type:Organization
Organization Name:POWER PULSE ELECTROLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ELECTROLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:IVY
Authorized Official - Middle Name:ALEJANDRA
Authorized Official - Last Name:CESENA-SINJUR
Authorized Official - Suffix:
Authorized Official - Credentials:LRE
Authorized Official - Phone:310-709-5649
Mailing Address - Street 1:1484 S BEVERLY DR APT 213
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-3066
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10351 SANTA MONICA BLVD STE 100
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-6935
Practice Address - Country:US
Practice Address - Phone:310-709-5649
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-19
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty