Provider Demographics
NPI:1689114126
Name:SD BEAUTY LAB
Entity Type:Organization
Organization Name:SD BEAUTY LAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUNNY
Authorized Official - Middle Name:K
Authorized Official - Last Name:ANH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-560-1212
Mailing Address - Street 1:7051 CLAIREMONT MESA BLVD STE 304B
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-1040
Mailing Address - Country:US
Mailing Address - Phone:858-560-1616
Mailing Address - Fax:858-560-1518
Practice Address - Street 1:7051 CLAIREMONT MESA BLVD STE 304B
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-1040
Practice Address - Country:US
Practice Address - Phone:858-560-1616
Practice Address - Fax:858-560-1518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-02
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies