Provider Demographics
NPI:1538887989
Name:BEAUTY BEATS CANCER
Entity type:Organization
Organization Name:BEAUTY BEATS CANCER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JON
Authorized Official - Middle Name:DESMOND
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-238-7552
Mailing Address - Street 1:15600 MULHOLLAND DR APT A
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90077-1519
Mailing Address - Country:US
Mailing Address - Phone:415-238-7552
Mailing Address - Fax:
Practice Address - Street 1:5823 S 23RD WAY
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85040-3499
Practice Address - Country:US
Practice Address - Phone:415-238-7552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-19
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier