Revival Health Medical Group

NPI #1194490342 in Los Angeles, California

Provider Information

NPI Number: 1194490342
Entity Type: Organization
Organization Name: Revival Health Medical Group
Primary Specialty: General Practice
Enumeration Date: Aug 10, 2021
Last Updated: Aug 10, 2021

Practice Location

Address: 4661 WILSHIRE BLVD UNIT 105
City: Los Angeles
State: California
ZIP Code: 90010-3931
Phone: (703) 326-2029

Authorized Official

Name: DR. EUGENE L. KIM, MD
Title: CEO
Phone: (703) 326-2029

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
General Practice	208D00000X	Primary

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