Provider Demographics
NPI:1295534576
Name:COLON HYDROTHERAPY & BEAUTY INC
Entity type:Organization
Organization Name:COLON HYDROTHERAPY & BEAUTY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LI
Authorized Official - Middle Name:
Authorized Official - Last Name:YOU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-612-7568
Mailing Address - Street 1:213 W WILSON ST STE E
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627-1667
Mailing Address - Country:US
Mailing Address - Phone:949-612-7508
Mailing Address - Fax:
Practice Address - Street 1:213 W WILSON ST STE E
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627-1667
Practice Address - Country:US
Practice Address - Phone:949-612-7508
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty