La Quinta Medspa, Inc.
NPI #1053506287 in La Quinta, California
Provider Information
- NPI Number
- 1053506287
- Entity Type
- Organization
- Organization Name
- La Quinta Medspa, Inc.
- Primary Specialty
- Specialist
- Enumeration Date
- Sep 11, 2007
- Last Updated
- Feb 22, 2010
Practice Location
- Address
- 47-350 WASHINGTON STREET
- Address 2
- SUITE 103
- City
- La Quinta
- State
- California
- ZIP Code
- 92253
- Phone
- (760) 396-9353
Authorized Official
- Name
- MATTHEW LOREN WERNER, M.D.
- Title
- MEDICAL DIRECTOR
- Phone
- (760) 396-9353
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist |
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