Provider Demographics
NPI:1972019628
Name:EXTENSIONS BY TASHI LLC
Entity Type:Organization
Organization Name:EXTENSIONS BY TASHI LLC
Other - Org Name:TASHI'S HAIR STUDIO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TASHI
Authorized Official - Middle Name:
Authorized Official - Last Name:CARR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-232-4429
Mailing Address - Street 1:560 N DIAMOND BAR BLVD
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-1007
Mailing Address - Country:US
Mailing Address - Phone:909-612-4295
Mailing Address - Fax:
Practice Address - Street 1:560 N DIAMOND BAR BLVD
Practice Address - Street 2:
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91765-1007
Practice Address - Country:US
Practice Address - Phone:909-612-4295
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TASHI'S HAIR STUDIO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-12-18
Last Update Date:2017-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier