REVIVAL HEALTH MEDICAL GROUP
NPI 1194490342
General Practice in Los Angeles, CA

Q: What is Revival Health Medical Group's NPI number?

The NPI number for Revival Health Medical Group is 1194490342. It was assigned to this organization in the NPPES registry on August 10, 2021.

Q: What is Revival Health Medical Group's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Active since August 10, 2021

4661 WILSHIRE BLVD UNIT 105, LOS ANGELES, CA 90010(703) 326-2029 Get Directions Write a Review

NPPES record last updated: August 10, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Revival Health Medical Group NPPES

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

REVIVAL HEALTH MEDICAL GROUP (NPI 1194490342) is a healthcare organization registered as a general practice in Los Angeles, California and active in the NPI registry since August 2021. The organization lists Eugene L. Kim, Ceo, as its authorized official.

NPPES Registry Identity

NPI1194490342

Entity TypeOrganization

Primary Taxonomy208D00000X

Legal Business NameREVIVAL HEALTH MEDICAL GROUP

Location Address4661 WILSHIRE BLVD UNIT 105Los Angeles, CA 90010-3931

Mailing Address1601 N Sepulveda Blvd # 103Manhattan Beach, CA 90266-5111 · (703) 326-2029

Phone(703) 326-2029

Organization SubpartNo

Authorized OfficialEugene L. KimCeo · (703) 326-2029

Enumeration DateAugust 10, 2021

NPPES CertifiedAugust 10, 2021

✔ NPI 1194490342 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

Definition

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

4661 WILSHIRE BLVD UNIT 105, Los Angeles, CA 90010

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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.

REVIVAL HEALTH MEDICAL GROUP PA

General Practice

4661 WILSHIRE BLVD UNIT 105
LOS ANGELES, CA 90010

Los Angeles County (703) 326-2029

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 Revival Health Medical Group's NPI number?

The NPI number for Revival Health Medical Group is 1194490342. It was assigned to this organization in the NPPES registry on August 10, 2021.

Where is Revival Health Medical Group located?

Revival Health Medical Group is located at 4661 Wilshire Blvd Unit 105, Los Angeles, CA 90010. The listed phone number is (703) 326-2029.

What is Revival Health Medical Group's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

When was this NPI record last updated?

The NPPES record for Revival Health Medical Group was last updated on August 10, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.