| Perfetta Medical Spa Inc | |
|
22015 Main St Ste B Carson CA 90745-2942 | |
| (424) 264-5859 | |
| (888) 444-9401 |
| Full Name | Perfetta Medical Spa Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 22015 Main St Ste B, Carson, California |
| Authorized Official Name and Position | Mark N Samonte (CEO) |
| Authorized Official Contact | 3108505630 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Perfetta Medical Spa Inc 22015 Main St Ste B Carson CA 90745-2942 Ph: (424) 264-5859 | Perfetta Medical Spa Inc 22015 Main St Ste B Carson CA 90745-2942 Ph: (424) 264-5859 |
| NPI Number | 1376026815 |
|---|---|
| Provider Enumeration Date | 09/11/2018 |
| Last Update Date | 09/11/2018 |
| Medicare PECOS PAC ID | 5890030142 |
|---|---|
| Medicare Enrollment ID | O20181214002118 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376026815 | NPI | - | NPPES |
| 083078A | Other | CA | BUSINESS LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Mark N Samonte |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1114140233 PECOS PAC ID: 5698872661 Enrollment ID: I20070525000580 |
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