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PACIFIC REJUVENATION MEDICAL, A PROFESSIONAL CORP.
NPI 1023428521
Non-Pharmacy Dispensing Site in Los Angeles, CA

Active since May 06, 2014
6310 SAN VICENTE BLVD, SUITE 220, LOS ANGELES, CA 90048(818) 518-5980(818) 337-2049 Get Directions Write a Review

NPPES record last updated: October 5, 2015. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Pacific Rejuvenation Medical, A Professional Corp. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PACIFIC REJUVENATION MEDICAL, A PROFESSIONAL CORP. (NPI 1023428521) is a healthcare organization registered as a non-pharmacy dispensing site in Los Angeles, California and active in the NPI registry since May 2014. The organization lists Lynn J. Goodloe, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1023428521
Entity TypeOrganization
Primary Taxonomy332900000X
Legal Business NamePACIFIC REJUVENATION MEDICAL, A PROFESSIONAL CORP.
Location Address6310 SAN VICENTE BLVD, SUITE 220Los Angeles, CA 90048-5426
Mailing Address2980 N Beverly Glen Cir, Suite 100Los Angeles, CA 90077-1726 · (310) 943-4180 · Fax (888) 431-8819
Phone(818) 518-5980
Fax(818) 337-2049
Organization SubpartYes
Authorized OfficialLynn J. GoodloeMedical Director · (818) 518-5980
Enumeration DateMay 6, 2014
Last NPPES UpdateOctober 5, 2015
✔ NPI 1023428521 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNon-Pharmacy Dispensing SiteSuppliers
Taxonomy Code332900000X
License✔ Licensed in CA · G44674
Definition
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.)
6310 SAN VICENTE BLVD, Los Angeles, CA 90048
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MICHAEL ADAM DOUGLAS PHD
Psychologist (Clinical)
6310 SAN VICENTE BLVD, SUITE 425
LOS ANGELES, CA 90048
Los Angeles County (310) 405-1948
DR. CHRISTINA L ADBERG MD
Obstetrics & Gynecology (Gynecology)
6310 SAN VICENTE BLVD, SUITE 330
LOS ANGELES, CA 90048
Los Angeles County (323) 452-9655
DR. MOHAMMAD ALI ANSARI M.D.
Internal Medicine (Pulmonary Disease)
6310 SAN VICENTE BLVD, SUITE 280
LOS ANGELES, CA 90048
Los Angeles County (323) 934-9265
MARK H. ROSSDANSON PH.D.
Psychologist
6310 SAN VICENTE BLVD, STE 410
LOS ANGELES, CA 90048
Los Angeles County (323) 932-1677
DR. SHARO RAISSI M.D.
Specialist
6310 SAN VICENTE BLVD, STE 220
LOS ANGELES, CA 90048
Los Angeles County (310) 291-2166
CYNTHIA RAJCHMAN MFTI
Marriage & Family Therapist
6310 SAN VICENTE BLVD, SUITE 415
LOSA ANGELES, CA 90048
Los Angeles County (213) 536-1314
HORIZON SLEEP MEDICINE SERVICES, INC
Internal Medicine (Pulmonary Disease)
6310 SAN VICENTE BLVD, SUITE 280
LOS ANGELES, CA 90048
Los Angeles County (323) 934-9262
LILY RUSSO APCC
Counselor (Professional)
6310 SAN VICENTE BLVD
LOS ANGELES, CA 90048
Los Angeles County (213) 262-3346

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pacific Rejuvenation Medical, A Professional Corp.'s NPI number?

The NPI number for Pacific Rejuvenation Medical, A Professional Corp. is 1023428521. It was assigned to this organization in the NPPES registry on May 6, 2014.

Where is Pacific Rejuvenation Medical, A Professional Corp. located?

Pacific Rejuvenation Medical, A Professional Corp. is located at 6310 San Vicente Blvd Suite 220, Los Angeles, CA 90048. The listed phone number is (818) 518-5980.

What is Pacific Rejuvenation Medical, A Professional Corp.'s specialty?

The primary specialty registered for this NPI is Non-Pharmacy Dispensing Site with taxonomy code 332900000X.

When was this NPI record last updated?

The NPPES record for Pacific Rejuvenation Medical, A Professional Corp. was last updated on October 5, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.