Overview
Name: REVIVAL HEALTH MEDICAL GROUP PA
Specialty: General Practice Physician
Type of Practice: Organization
Provider/Org:
Medical School:
Graduation year from medical school:
Affiliation:
Specialties
Practice Type: Allopathic & Osteopathic Physicians
Classification: General Practice
Specialization: .
Definition of Specialty: Definition to come…
License & NPI
License #(s): , , , ,
License State(s): , , , ,
Addresses
Practice Location: REVIVAL HEALTH MEDICAL GROUP PA,4661 WILSHIRE BLVD UNIT 105,LOS ANGELES,CA,900103931,US
Mailing Address: REVIVAL HEALTH MEDICAL GROUP PA,1601 N SEPULVEDA BLVD # 103,MANHATTAN BEACH,CA,902665111,US
Contact #
Practice location phone #: 7033262029
Practice location fax #:
Mailing address Phone #: 7033262029
Mailing Address fax #:
Authorized official Name/Telephone #:DR., EUGENE, L., KIM, MD, PRESIDENT 7033262029
Misc
Date NPI was obtained: 08/27/2021
Last data data was updated: 08/27/2021
Insurances: