AGEREVERSALMD.COM A PROFESSIONAL CORPORATION
NPI 1194450023
Public Health or Welfare in La Jolla, CA

Q: What is Agereversalmd.Com A Professional Corporation's specialty?

The primary specialty registered for this NPI is Public Health or Welfare with taxonomy code 251K00000X.

Active since July 24, 2022

3252 HOLIDAY CT STE 211, LA JOLLA, CA 92037(858) 776-0544(760) 692-4411 Get Directions Write a Review

NPPES record last updated: July 24, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Agereversalmd.com A Professional Corporation NPPES

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

AGEREVERSALMD.COM A PROFESSIONAL CORPORATION (NPI 1194450023) is a healthcare organization registered as a public health or welfare in La Jolla, California and active in the NPI registry since July 2022. The organization maintains a secondary practice location in Carlsbad and lists Phillip Mark Milgram, Ceo, as its authorized official.

NPPES Registry Identity

NPI1194450023

Entity TypeOrganization

Primary Taxonomy251K00000X

Legal Business NameAGEREVERSALMD.COM A PROFESSIONAL CORPORATION

Location Address3252 HOLIDAY CT STE 211La Jolla, CA 92037-0027

Mailing Address444 N El Camino Real Spc 123Encinitas, CA 92024-1317 · (858) 776-0544 · Fax (760) 692-4411

Phone(858) 776-0544

Fax(760) 692-4411

Organization SubpartNo

Authorized OfficialPhillip Mark MilgramCeo · (858) 776-0544

Enumeration DateJuly 24, 2022

NPPES CertifiedJuly 24, 2022

✔ NPI 1194450023 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyPublic Health or WelfareAgencies

Taxonomy Code251K00000X

Also ListedObstetrics & Gynecology · GynecologyTaxonomy 207VG0400X

Also ListedClinic/Center · Primary CareTaxonomy 261QP2300X

Also ListedClinic/Center · PainTaxonomy 261QP3300X

3252 HOLIDAY CT STE 211, La Jolla, CA 92037

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Secondary Practice Location 1

Location 11207 Carlsbad Village Dr Ste QCarlsbad, CA 92008-1958 · Phone (760) 944-9200 · Fax (760) 692-4411

Other Identifiers 1

Other1285737569CA · Individual Npi

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES

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

THE WELLNESS INSTITUTE

Physician Assistant (Medical)

3252 HOLIDAY CT STE 211
LA JOLLA, CA 92037

San Diego County (844) 384-2476

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 Agereversalmd.Com A Professional Corporation's NPI number?

The NPI number for Agereversalmd.Com A Professional Corporation is 1194450023. It was assigned to this organization in the NPPES registry on July 24, 2022.

Where is Agereversalmd.Com A Professional Corporation located?

Agereversalmd.Com A Professional Corporation is located at 3252 Holiday Ct Ste 211, La Jolla, CA 92037. The listed phone number is (858) 776-0544.

What is Agereversalmd.Com A Professional Corporation's specialty?

The primary specialty registered for this NPI is Public Health or Welfare with taxonomy code 251K00000X.

When was this NPI record last updated?

The NPPES record for Agereversalmd.Com A Professional Corporation was last updated on July 24, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.