institution
Revival Health Medical Group
General Practice Physician in Los Angeles, California
NPI 1194490342

Revival Health Medical Group is a General Practice Physician based in Manhattan Beach, CA. Revival Health Medical Group practices in Los Angeles, CA. The NPI Number for Revival Health Medical Group is 1194490342 and holds a License No. (California).

The current practice location address for Revival Health Medical Group is 4661 Wilshire Blvd Unit 105, Los Angeles, CA and can be reached out via phone at 703-326-2029.

Location: 4661 Wilshire Blvd Unit 105, Los Angeles, CA, 90266-5111
institution
Provider Profile Details
NPI Number
1194490342
Provider Name
Revival Health Medical Group
Credential
Provider Entity Type
Organization
Address
4661 Wilshire Blvd Unit 105, Los Angeles, CA, 90266-5111
Phone Number
703-326-2029
Fax Number
Provider Enumeration Date
08/10/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
4661 Wilshire Blvd Unit 105
City
State
Zip
90010-3931
Phone Number
703-326-2029
Fax Number
person
Provider Business Mailing Address Details
Address
4661 Wilshire Blvd Unit 105
City
State
Zip
90010-3931
Phone Number
703-326-2029
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
License No.
()
Definition
Definition to come...
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