Provider Demographics
NPI:1861983884
Name:BEVERLY HILLS HAIR FREE CORP
Entity type:Organization
Organization Name:BEVERLY HILLS HAIR FREE CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALANA
Authorized Official - Middle Name:
Authorized Official - Last Name:DZUREK
Authorized Official - Suffix:
Authorized Official - Credentials:ELECTROLOGIST
Authorized Official - Phone:424-208-4318
Mailing Address - Street 1:9301 WILSHIRE BLVD #310
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210
Mailing Address - Country:US
Mailing Address - Phone:424-335-0025
Mailing Address - Fax:424-335-0155
Practice Address - Street 1:9301 WILSHIRE BLVD #310
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210
Practice Address - Country:US
Practice Address - Phone:424-335-0025
Practice Address - Fax:424-335-0155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-24
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL9417171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherLA CARE