PACIFIC REJUVENATION MEDICAL, A PROFESSIONAL CORP. is a non pharmacy dispensing site in Los Angeles, CA. The provider is a site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) PACIFIC REJUVENATION MEDICAL, A PROFESSIONAL CORP. NPI is 1023428521. The provider is registered as an organization entity type.
The provider's business location address is:
6310 SAN VICENTE BLVD
SUITE 220
LOS ANGELES, CA
ZIP 90048-426
Phone: (818) 518-5980
Fax: (818) 337-2049
The provider's authorized official is Lynn J. Goodloe .
The authorized official title is Medical Director and has the following contact phone number (818) 518-5980.
The enumeration date for this NPI number is 5/6/2014 and was last updated on 10/5/2015.