Provider Demographics
NPI:1295983450
Name:SMOOTH AESTHETICS INC, A MEDICAL CORP
Entity type:Organization
Organization Name:SMOOTH AESTHETICS INC, A MEDICAL CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE-PRES
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:H
Authorized Official - Last Name:FINK
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:818-954-0510
Mailing Address - Street 1:1510 W VERDUGO AVE
Mailing Address - Street 2:STE E
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91506-2472
Mailing Address - Country:US
Mailing Address - Phone:818-954-0510
Mailing Address - Fax:818-954-0419
Practice Address - Street 1:1510 W VERDUGO AVE
Practice Address - Street 2:STE E
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-2472
Practice Address - Country:US
Practice Address - Phone:818-954-0510
Practice Address - Fax:818-954-0419
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-29
Last Update Date:2008-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29743111N00000X
CAA78999207Q00000X
CAA78697207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty