Provider Demographics
NPI:1225783624
Name:HEARTEN ELECTROLYSIS, LLC
Entity Type:Organization
Organization Name:HEARTEN ELECTROLYSIS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:AMPON
Authorized Official - Suffix:
Authorized Official - Credentials:LE
Authorized Official - Phone:415-470-0140
Mailing Address - Street 1:900 BUSH STREET
Mailing Address - Street 2:#413
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109
Mailing Address - Country:US
Mailing Address - Phone:415-999-3931
Mailing Address - Fax:
Practice Address - Street 1:1528 1/2 CALIFORNIA STREET
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109
Practice Address - Country:US
Practice Address - Phone:415-470-0140
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEARTEN ELECTROLYSIS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-02-15
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty