Organization · Type 2 NPI
Revival Health Medical Group PA
General Practice Physician · Los Angeles, CA
NPI number
1730856659
Active
Practice location
4661 Wilshire Blvd Unit 105
Los Angeles, CA 90010-3931
Mailing address
1601 N Sepulveda Blvd # 103
Manhattan Beach, CA 90266-5111
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| General Practice Physician Primary | 208D00000X | None listed |
General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
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About NPI 1730856659
Revival Health Medical Group PA's National Provider Identifier is 1730856659, issued on Aug 27, 2021. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Los Angeles, CA. The record was last updated on Aug 27, 2021.