Provider Demographics
NPI:1063242261
Name:CAT & MOUSE ELECTROLYSIS
Entity type:Organization
Organization Name:CAT & MOUSE ELECTROLYSIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:NOEL
Authorized Official - Suffix:
Authorized Official - Credentials:ELECTROLOGIST
Authorized Official - Phone:909-243-1996
Mailing Address - Street 1:159 N MARENGO AVE APT 102
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-4505
Mailing Address - Country:US
Mailing Address - Phone:909-206-2443
Mailing Address - Fax:
Practice Address - Street 1:1 W CALIFORNIA BLVD STE 228
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3033
Practice Address - Country:US
Practice Address - Phone:909-206-2443
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-03
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1538906771Medicaid
CA1154151355Medicaid
CA1770321929Medicaid