Deja Vu Medspa

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

G17614 Issued in CA

Legal business name

DEJA VU MEDSPA

Doing business as

Deja Vu Med Spa

Practice address

38 E Huntington Dr
Arcadia, CA 91006-3253

Phone

(626) 696-0049

NPI assigned

Apr 13, 2018

Last updated

Apr 13, 2018By 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

Dr. John P Beauclair, MDNPI 1144248477

Title

Owner6266960049

Phone

(626) 696-0049

Specialties & licenses 1

Addresses

Other names 1

• Deja Vu Med Spa Doing business as

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.

• John P Beauclair, M.D.

  • General Practice Physician
  • Arcadia, CA
  • NPI 1144248477
  Authorized official Same address or phone

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

{
    "created_epoch": "1523577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523577600000",
    "number": "1902393168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 E HUNTINGTON DR",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910063253",
            "telephone_number": "626-696-0049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 E HUNTINGTON DR",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910063253",
            "telephone_number": "626-696-0049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEJA VU MEDSPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-13",
        "last_updated": "2018-04-13",
        "status": "A",
        "authorized_official_last_name": "BEAUCLAIR",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER6266960049",
        "authorized_official_telephone_number": "626-696-0049",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "G17614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Deja Vu Med Spa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Deborah Duan OD, Aoc (Infocus Vision Optometric Center)
• Samantha Dee
• Kayla Defrance
• Roshanak K Dehkordi, MD
• Ceanna Deita
• Diana Del Carlo, M.D.
• Brian Delgado
• Claudia Crystal Delgado
• Monica Irene Delgado, PH.D.
• Sarah Delgado, PTA

• Primary Care Clinic/Center in Arcadia, CA
• Providers in Arcadia, 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 Apr 13, 2018; 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.