SOUTH BAY REGENERATIVE MEDICAL SPA INC (NPI# 1033733779) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033733779 |
| Entity Type | Organization |
| Organization Name | SOUTH BAY REGENERATIVE MEDICAL SPA INC |
| Practice Address |
412 S Pacific Coast Hwy Ste 100 Redondo Beach CA 90277-3712 |
| Practice Telephone | 3107929100 |
| Practice Fax Number | 3107921180 |
| Mailing Telephone | 3107929100 |
| Mailing Fax Number | 3107921180 |
| Enumeration Date | 2020-05-28 |
| Last Update Date | 2020-05-28 |
| Authorized Official Name | MICHELLE VILLA (BILLING DEPT) |
| Authorized Official Telephone | 8054749053 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Body Care Regenerative Medicine | Doing Business As Name - Organization |
| Street Address |
412 S PACIFIC COAST HWY STE 100 |
| City | REDONDO BEACH |
| State | CA |
| Zip Code | 90277-3712 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780215103 | Robert John Coffman | Psychologist | 316b North Pacific Coast Hwy., Redondo Beach, CA 90277 | 2020-02-04 |
| 1952949786 | Anne E Pitts | Dietitian, Registered | 360 The Village Drive Unit 207, Redondo Beach, CA 90277 | 2019-12-11 |
| 1558916841 | Dana Bryon Staub | Social Worker | 205 Ave. I, Suite 17, Redondo Beach, CA 90277 | 2019-08-05 |
| 1376033860 | Lisa Ann Graziano | Marriage & Family Therapist | 514 N. Prospect Avenue, Suite 111 Lower Level, Redondo Beach, CA 90277 | 2018-05-10 |
| 1275981326 | Carla Marie Vasquez | Marriage & Family Therapist | 901 N. Pacific Coast Highway, 200a, Redondo Beach, CA 90277 | 2016-05-31 |
| 1154793628 | Marianne M. Cuttic, Dpm, Inc | Podiatrist | 1970 S Prospect Avenue, Suite 4, Redondo Beach, CA 90277 | 2015-10-23 |
| 1841682994 | Mary Schopfel | Counselor | 901 Pacific Coast Highway, 200a, Redondo Beach, CA 90277 | 2015-02-26 |
| 1700287141 | Rose Ross | Marriage & Family Therapist | 901 North Pacific Coast Highway, Suite 200a, Redondo Beach, CA 90277 | 2014-09-04 |
| 1912307661 | Gale Hazeltine | Physical Therapist | 409 N PCh Hwy # 308, Redondo Beach, CA 90277 | 2014-08-31 |
| 1194135889 | Physical Therapy Concierge Service Inc | Clinic/Center | 704 N. Irena, B, Redondo Beach, CA 90277 | 2014-05-02 |
| Find all providers in zip 90277 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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|---|---|---|---|---|
| 1114571718 | Advanced Integrative Medical Center, Inc. | General Practice | 410 Torrance Blvd, Redondo Beach, CA 90277-3325 | 2019-07-31 |
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| 1316553530 | Kimberly Ann Callaway | General Practice | 4893 Drakewood Ter, San Diego, CA 92130-1406 | 2020-09-22 |
| 1376156109 | Gtl Medical Group Inc | General Practice | 14555 Hamlin St Ste 107, Van Nuys, CA 91411-1617 | 2020-08-31 |
| 1922611896 | Daniel Lynn Johnson | General Practice | 74075 El Paseo Ste B2, Palm Desert, CA 92260-4118 | 2020-08-28 |
| 1235755299 | Hofmeister Medical, PC | General Practice | 31735 Riverside Dr Ste K, Lake Elsinore, CA 92530-7816 | 2020-06-24 |
| 1568085041 | Integrated Advanced Medicine Inc | General Practice | 210 S Grand Ave Ste 408, Glendora, CA 91741-4282 | 2020-05-19 |
| 1851913917 | St Bishoy Medical Group | General Practice | 8545 Saturn St Apt 103, Los Angeles, CA 90035-3658 | 2020-05-12 |
| Find all providers with the same taxonomy | ||||
| City | REDONDO BEACH |
| Zip Code | 90277 |
Please comment or provide details below to improve the information on SOUTH BAY REGENERATIVE MEDICAL SPA INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.