Provider Demographics
NPI:1972398600
Name:ESTHETICS QUEENDOM LLC
Entity type:Organization
Organization Name:ESTHETICS QUEENDOM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ LICENSED ESTHETICIAN
Authorized Official - Prefix:
Authorized Official - First Name:DOMINIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOBINEAUX
Authorized Official - Suffix:
Authorized Official - Credentials:LE
Authorized Official - Phone:510-999-0904
Mailing Address - Street 1:30042 MISSION BLVD STE 121
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94544-7255
Mailing Address - Country:US
Mailing Address - Phone:510-999-0904
Mailing Address - Fax:
Practice Address - Street 1:24301 SOUTHLAND DR STE 505
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94545-1553
Practice Address - Country:US
Practice Address - Phone:510-209-6295
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-12
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty