Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

The Botox Spot Physician Assistant Corporation

Organization Medical Specialty Clinic/Center · NPI 1710756390

The Botox Spot Physician Assistant Corporation is a Medical Specialty Clinic/Center in Redlands, California. Registered with an NPI since 2023.

In the registry since
2023

Practice location Address checks out

914 Orange St Ste E
Redlands, CA 92374-3281
Phone: (909) 752-6869
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Specialty Clinic/Center (primary) Taxonomy 261QM2500X

Record details

NPI number1710756390
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Andrew Russ — Owner · (909) 752-6869
Other names The Botox Spot; The Botox Spot Physician Assistant Corporation
NPI enumeratedDecember 25, 2023
Last updated in NPPESDecember 25, 2023
Certification dateDecember 24, 2023
Mailing address1083 Raven Ct, Calimesa, CA 92320-4921

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