REVIVE MEDICAL OF SAN DIEGO NPI 1114484573

NPI Information

REVIVE MEDICAL OF SAN DIEGO is a general practice in San Diego, CA. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee REVIVE MEDICAL OF SAN DIEGO NPI is 1114484573. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

7220 TRADE ST STE 209
SAN DIEGO, CA
ZIP 92121-326
Phone: (858) 800-1006

The provider's authorized official is Kevin Brown .
The authorized official title is Owner/provider and has the following contact phone number (951) 440-1652.

The enumeration date for this NPI number is 2/21/2019 and was last updated on 2/21/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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