Vida Revival Medical Corporation
NPI #1780560870 in Thousand Oaks, California
Provider Information
- NPI Number
- 1780560870
- Entity Type
- Organization
- Organization Name
- Vida Revival Medical Corporation
- Primary Specialty
- Clinic/Center - Primary Care
- Enumeration Date
- Aug 13, 2025
- Last Updated
- Aug 13, 2025
Practice Location
- Address
- 3180 WILLOW LN STE 114
- City
- Thousand Oaks
- State
- California
- ZIP Code
- 91361-4984
- Phone
- (818) 232-8432
Authorized Official
- Name
- DR. DIANA ALAVI, MD/ CEO
- Title
- MD/ CEO
- Phone
- (818) 232-8452
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Primary Care — Primary Care |
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