| Genesis Medspa, Inc | |
|
22323 Sherman Way Suite # 19-20 Canoga Park CA 91303-1002 | |
| (818) 884-8110 | |
| (805) 832-4301 |
| Full Name | Genesis Medspa, Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 22323 Sherman Way, Canoga Park, California |
| Authorized Official Name and Position | Margarita Lozada Fernandez (SECRETARY) |
| Authorized Official Contact | 8582543762 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Genesis Medspa, Inc 1216 Bayside Cir Oxnard CA 93035-2147 Ph: () - | Genesis Medspa, Inc 22323 Sherman Way Suite # 19-20 Canoga Park CA 91303-1002 Ph: (818) 884-8110 |
| NPI Number | 1992048250 |
|---|---|
| Provider Enumeration Date | 04/04/2013 |
| Last Update Date | 04/04/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992048250 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A-26431 (California) | Primary |
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