| Eternal Beauty Medical Clinic, Inc | |
|
248 Los Gatos Saratoga Rd Los Gatos CA 95030-5317 | |
| (408) 354-3587 | |
| (408) 354-3651 |
| Full Name | Eternal Beauty Medical Clinic, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 248 Los Gatos Saratoga Rd, Los Gatos, California |
| Authorized Official Name and Position | Forouzan Vaghar (PRESIDENT) |
| Authorized Official Contact | 4083543587 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eternal Beauty Medical Clinic, Inc 248 Los Gatos Saratoga Rd Los Gatos CA 95030-5317 Ph: (408) 354-3587 | Eternal Beauty Medical Clinic, Inc 248 Los Gatos Saratoga Rd Los Gatos CA 95030-5317 Ph: (408) 354-3587 |
| NPI Number | 1033282892 |
|---|---|
| Provider Enumeration Date | 11/17/2006 |
| Last Update Date | 07/13/2015 |
| Medicare PECOS PAC ID | 8527066703 |
|---|---|
| Medicare Enrollment ID | O20061122000382 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033282892 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | A063086 (California) | Primary |
| Provider Name | Forouzan Vaghar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578671905 PECOS PAC ID: 2860450806 Enrollment ID: I20041222000448 |
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