| Enliven Aesthetic Medical Clinic | |
|
23141 Moulton Pkwy Ste 202 Laguna Hills CA 92653-1241 | |
| (949) 305-2711 | |
| (949) 502-8887 |
| Full Name | Enliven Aesthetic Medical Clinic |
|---|---|
| Speciality | Internal Medicine - Geriatric Medicine |
| Location | 23141 Moulton Pkwy Ste 202, Laguna Hills, California |
| Authorized Official Name and Position | Mozhgan Ashtari (CEO/ MD) |
| Authorized Official Contact | 5512065779 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Enliven Aesthetic Medical Clinic 23141 Moulton Pkwy Ste 202 Laguna Hills CA 92653-1241 Ph: (949) 305-2711 | Enliven Aesthetic Medical Clinic 23141 Moulton Pkwy Ste 202 Laguna Hills CA 92653-1241 Ph: (949) 305-2711 |
| NPI Number | 1518465665 |
|---|---|
| Provider Enumeration Date | 01/24/2018 |
| Last Update Date | 01/24/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518465665 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | A111582 (California) | Primary |
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