| Organization Name: | LEJOLIE MEDICAL SPA |
| NPI Number: | 1962836361 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PARVANEH RAFAELOFF (MEDICAL DIRECTOR) |
| Mailing Address: | 13041 Ventura Blvd Studio City |
| State: | CA US |
| Postal Code: | 916042237 |
| Phone Number: | 8185011114 |
| Fax Number: | 8185011116 |
| NPI Enumeration Date: | 08/21/2013 |
| NPI Last Update Date: | 08/21/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 302R00000X |
| License Number: | A52350 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Managed Care Organizations |
| Taxonomy Classification: | Health Maintenance Organization |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) A form of health insurance in which its members prepay a premium for the HMO |