Provider Demographics
NPI:1487419735
Name:LINA'S ELECTROLYSIS CENTER LLC
Entity type:Organization
Organization Name:LINA'S ELECTROLYSIS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LINA
Authorized Official - Middle Name:
Authorized Official - Last Name:NUNEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-261-7956
Mailing Address - Street 1:6117 BROCKTON AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-2282
Mailing Address - Country:US
Mailing Address - Phone:951-261-7956
Mailing Address - Fax:
Practice Address - Street 1:6117 BROCKTON AVE STE 105
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-2282
Practice Address - Country:US
Practice Address - Phone:951-261-7956
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-15
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No171W00000XOther Service ProvidersContractor