Organization Active NPI

Supernatural Beauty & Aesthetics Medical Group, PC

  • Family Medicine Physician
  • Ben Lomond, CA
National Provider Identifier
1699650267
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SUPERNATURAL BEAUTY & AESTHETICS MEDICAL GROUP, PC
Practice address
10090 Highway 9 Ste 8
Ben Lomond, CA 95005-9251
Phone
(661) 889-5728
NPI assigned
Aug 11, 2025
Last updated
Aug 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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

Authorized official

Name
Brandi Phillips, RNNPI 1679368328
Title
Secretary
Phone
(661) 889-5728

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

10090 Highway 9 Ste 8
Ben Lomond, CA 95005-9251

Mailing address

10090 Highway 9 Ste 8
Ben Lomond, CA 95005-9251

National Provider Directory

National Provider Directory

Locations

10090 Highway 9
Ste 8
Ben Lomond, CA 95005
Phone (661) 889-5728

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1754870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754870400000",
    "number": "1699650267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10090 HIGHWAY 9 STE 8",
            "city": "BEN LOMOND",
            "state": "CA",
            "postal_code": "950059251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10090 HIGHWAY 9 STE 8",
            "city": "BEN LOMOND",
            "state": "CA",
            "postal_code": "950059251",
            "telephone_number": "661-889-5728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPERNATURAL BEAUTY & AESTHETICS MEDICAL GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-11",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "BRANDI",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "661-889-5728",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ben Lomond, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.