Aesthetica Clinique Llc

LBN: Aesthetica Clinique Llc
Aesthetica Clinique Llc is an health care organization with primary practice located at 801 Pacific Ave , Tacoma WA 98402-5209. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic Surgery, which is considered as the primary health care specialty. Aesthetica Clinique Llc can be contacted via phone (229) 589-2588, or through Potyondy, Louis David via phone (229) 589-2588.

Contact Information

Primary practice address
801 Pacific Ave Tacoma WA 98402-5209
Phone: (229) 589-2588
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Potyondy, Louis David Doctor of Medicine (MD)
Phone: (229) 589-2588

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic Surgery 208200000X MD 60288108 Washington

Profile Details

NPI number 1508824293
LBN Legal business name Aesthetica Clinique Llc
DBA Doing business as
Authorized official Potyondy, Louis David Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date May 2nd, 2006
Last updated Sep 11th, 2012 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508824293 NPPES
Georgia MEDICAID 569370029A
Georgia Other 1104884956

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