Revive Medical Group Ca PC
NPI #1518724624 in Mount Shasta, California
Provider Information
- NPI Number
- 1518724624
- Entity Type
- Organization
- Organization Name
- Revive Medical Group Ca PC
- Primary Specialty
- Psychiatry & Neurology - Psychiatry
- Enumeration Date
- Mar 5, 2024
- Last Updated
- Mar 5, 2024
Practice Location
- Address
- 914 PINE ST
- City
- Mount Shasta
- State
- California
- ZIP Code
- 96067-2143
- Phone
- (203) 430-1321
Authorized Official
- Name
- OMAR ZIYADEH
- Title
- CEO/MANAGER
- Phone
- (203) 430-1321
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychiatry & Neurology - Psychiatry — Psychiatry |
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