Provider Demographics
NPI:1497553218
Name:PANTHEON BODY CARE
Entity type:Organization
Organization Name:PANTHEON BODY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED ELECTROLOGIST , OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARTEMIS
Authorized Official - Middle Name:
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:LE
Authorized Official - Phone:415-494-9468
Mailing Address - Street 1:1146 SONATA DR
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94591-3876
Mailing Address - Country:US
Mailing Address - Phone:415-494-9468
Mailing Address - Fax:
Practice Address - Street 1:4713 1ST ST
Practice Address - Street 2:#252
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-7376
Practice Address - Country:US
Practice Address - Phone:415-494-9468
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-06
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty