Provider Demographics
NPI:1588125835
Name:BEAUTY ETERNAL, INC
Entity type:Organization
Organization Name:BEAUTY ETERNAL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:C
Authorized Official - Last Name:HARTMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:530-487-5020
Mailing Address - Street 1:PO BOX 8508
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95927-8508
Mailing Address - Country:US
Mailing Address - Phone:530-487-5020
Mailing Address - Fax:
Practice Address - Street 1:1260 EAST AVE STE 130
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-1021
Practice Address - Country:US
Practice Address - Phone:530-487-5020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-28
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA129965OtherCALIFORNIA PHYSICIAN LICENSE