Eternal Beauty Medical Clinic, Inc

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

A063086 Issued in CA

Legal business name

ETERNAL BEAUTY MEDICAL CLINIC, INC

Practice address

248 Los Gatos Saratoga Rd
Los Gatos, CA 95030-5317

Phone

(408) 354-3587

Fax

(408) 354-3651

NPI assigned

Nov 17, 2006

Last updated

Jul 13, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Forouzan VagharNPI 1578671905

Title

President

Phone

(408) 354-3587

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Forouzan Vaghar, M.D.

  • Internal Medicine Physician
  • Los Gatos, CA
  • NPI 1578671905
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436745600000",
    "number": "1033282892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "248 LOS GATOS SARATOGA RD",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950305317",
            "telephone_number": "408-354-3587",
            "fax_number": "408-354-3651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "248 LOS GATOS SARATOGA RD",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950305317",
            "telephone_number": "408-354-3587",
            "fax_number": "408-354-3651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETERNAL BEAUTY MEDICAL CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2015-07-13",
        "status": "A",
        "authorized_official_last_name": "VAGHAR",
        "authorized_official_first_name": "FOROUZAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "408-354-3587"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "A063086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Escalera
• Orval Myron Eshelman, M.D.
• Esther Chen, MD, PC
• Michelle Estrada-Jimenez
• Olivia Ann Estrella
• Michelle Evans
• Richard H Evans, DDS
• Susan Everest, PT
• Exceptional Care LLC
• Eye Contact Optometry

• Primary Care Clinic/Center in Los Gatos, CA
• Providers in Los Gatos, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.