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THE BOTOX SPOT PHYSICIAN ASSISTANT CORPORATION
NPI 1710756390
Clinic/Center - Medical Specialty in Redlands, CA

Active since December 25, 2023
914 ORANGE ST STE E, REDLANDS, CA 92374(909) 752-6869 Get Directions Write a Review

NPPES record last updated: December 25, 2023. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About The Botox Spot Physician Assistant Corporation NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THE BOTOX SPOT PHYSICIAN ASSISTANT CORPORATION (NPI 1710756390), doing business as The Botox Spot, is a healthcare organization registered as a medical specialty in Redlands, California and active in the NPI registry since December 2023. The organization lists Andrew Russ, Owner, as its authorized official.

NPPES Registry Identity

NPI1710756390
Entity TypeOrganization
Primary Taxonomy261QM2500X
Legal Business NameTHE BOTOX SPOT PHYSICIAN ASSISTANT CORPORATION
Location Address914 ORANGE ST STE ERedlands, CA 92374-3281
Mailing Address1083 Raven CtCalimesa, CA 92320-4921 · (909) 752-6869
Phone(909) 752-6869
Organization SubpartNo
Authorized OfficialAndrew RussOwner · (909) 752-6869
Enumeration DateDecember 25, 2023
NPPES CertifiedDecember 24, 2023
✔ NPI 1710756390 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Medical SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM2500X
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
914 ORANGE ST STE E, Redlands, CA 92374
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Other Names 2

Doing Business AsThe Botox Spot
Doing Business AsThe Botox Spot Physician Assistant Corporation

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is The Botox Spot Physician Assistant Corporation's NPI number?

The NPI number for The Botox Spot Physician Assistant Corporation is 1710756390. It was assigned to this organization in the NPPES registry on December 25, 2023. The provider is doing business as The Botox Spot.

Where is The Botox Spot Physician Assistant Corporation located?

The Botox Spot Physician Assistant Corporation is located at 914 Orange St Ste E, Redlands, CA 92374. The listed phone number is (909) 752-6869.

What is The Botox Spot Physician Assistant Corporation's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Medical Specialty, with taxonomy code 261QM2500X.

When was this NPI record last updated?

The NPPES record for The Botox Spot Physician Assistant Corporation was last updated on December 25, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.