Revive Medical Group Ca PC
Psychiatry & Neurology, Psychiatry in Mount Shasta, California
1518724624- Practice location
- 914 Pine St, Mount Shasta, CA 96067-2143
- Phone
- 203-430-1321
- Fax
- —
- Last updated
- March 5, 2024
Revive Medical Group Ca PC is a healthcare organization based in Mount Shasta, CA. Revive Medical Group Ca PC practices in Mount Shasta, CA. The NPI Number for Revive Medical Group Ca PC is 1518724624. The current practice location address for Revive Medical Group Ca PC is 914 Pine St, Mount Shasta, CA 96067-2143 and can be reached out via phone at 203-430-1321.
Provider Profile Details
- NPI Number
- 1518724624
- Provider Name
- Revive Medical Group Ca PC
- Provider Entity Type
- Organization
- Address
- 914 Pine St, Mount Shasta, CA 96067-2143
- Phone Number
- 203-430-1321
- Primary Taxonomy
- Psychiatry & Neurology, Psychiatry · 2084P0800X
- Organization Subpart
- No
- Authorized Official
- Omar Ziyadeh · Ceo/Manager · 203-430-1321
- Provider Enumeration Date
- March 5, 2024
- Last Update Date
- March 5, 2024
- Certification Date
- March 5, 2024
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 914 Pine St
Mount Shasta, CA 96067-2143 - City
- Mount Shasta
- State
- California
- Zip
- 96067-2143
- Phone Number
- 203-430-1321
Provider Business Mailing Address Details
- Address
- 81 Roanoke Ave
Fairfield, CT 06824-6124 - City
- Fairfield
- State
- CT
- Zip
- 06824-6124
- Phone Number
- 203-430-1321
License Information
- Taxonomy
- Psychiatry & Neurology, Psychiatry · 2084P0800X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Psychiatry & Neurology, Psychiatry providers near Mount Shasta, CA
View all Psychiatry & Neurology, Psychiatry providers in Mount Shasta →Frequently Asked Questions
What is the NPI number of Revive Medical Group Ca PC?
The NPI number of Revive Medical Group Ca PC is 1518724624. It was assigned on March 5, 2024 and is currently active in the NPPES registry.
What is the specialty of Revive Medical Group Ca PC?
Revive Medical Group Ca PC is registered under the primary taxonomy Psychiatry & Neurology, Psychiatry (code 2084P0800X).
Where does Revive Medical Group Ca PC practice?
The practice location is 914 Pine St, Mount Shasta, CA 96067-2143. The office can be reached at 203-430-1321 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1518724624 directly on the NPPES registry website.