Provider Demographics
NPI:1699421917
Name:AESTHETICALLY YOURS INC
Entity type:Organization
Organization Name:AESTHETICALLY YOURS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:ASIF
Authorized Official - Last Name:TAQI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-984-0921
Mailing Address - Street 1:2190 LYNN RD STE 380B
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-1980
Mailing Address - Country:US
Mailing Address - Phone:818-964-0921
Mailing Address - Fax:
Practice Address - Street 1:2190 LYNN RD STE 380B
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-1980
Practice Address - Country:US
Practice Address - Phone:818-964-0921
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-24
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center