REVIVE WELLNESS CENTER (NPI# 1013372242) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1013372242 |
Entity Type | Organization |
Organization Name | REVIVE WELLNESS CENTER |
Practice Address |
22330 Hawthorne Blvd Suite J Torrance CA 90505-2536 |
Practice Telephone | 3103757599 |
Practice Fax Number | 3104140777 |
Mailing Telephone | 3103757599 |
Mailing Fax Number | 3104140777 |
Enumeration Date | 2015-12-14 |
Last Update Date | 2015-12-14 |
Authorized Official Name | SHONDA CHASE (OWNER) |
Authorized Official Telephone | 3103757599 |
Authorized Official Credential | FNP |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
95003531 | CA | Ambulatory Health Care Facilities |
Entity Type | Entity Name | Entity Address |
---|---|---|
Colorado Business Entities | Revive Wellness Center LLC | 6657 W Ottawa Ave, A11, Littleton, CO 80128 |
Connecticut Business Registrations | REVIVE WELLNESS CENTER, LLC | 867-869 Whalley Avenue, New Haven, CT 06515 |
Street Address |
22330 HAWTHORNE BLVD SUITE J |
City | TORRANCE |
State | CA |
Zip Code | 90505-2536 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1720186794 | Wayne T Tofukuji | Dentist | 22330 Hawthorne Blvd, Suite 312, Torrance, CA 90505 | 2006-09-21 |
1578013066 | Steven K Okamoto Dds Inc | Dentist | 22330 Hawthorne Blvd, Suite E, Torrance, CA 90505-2536 | 2016-10-07 |
1821469461 | Endocrine Care Specialists, Inc | Internal Medicine | 22330 Hawthorne Blvd, Ste 207, Torrance, CA 90505-2536 | 2015-10-08 |
1649646050 | Firstpoint Behavioral and Addictio | Substance Abuse Rehabilitation Facility | 22330 Hawthorne Blvd, Suite 204, Torrance, CA 90505-2536 | 2015-08-19 |
1689053530 | Steven K Okamoto | Clinic/Center | 22330 Hawthorne Blvd, Suite E, Torrance, CA 90505 | 2015-05-26 |
1487082426 | Michelle Okamoto | Dentist | 22330 Hawthorne Blvd, Suite E, Torrance, CA 90505-2536 | 2013-10-30 |
1982038345 | Guilda Sarraf, M.d., Inc. | Internal Medicine | 22330 Hawthorne Blvd, Suite 205, Torrance, CA 90505-2536 | 2013-08-21 |
1245516491 | Yanase Dental Group | Dentist | 22330 Hawthorne Blvd, 316, Torrance, CA 90505-2536 | 2011-11-01 |
1235427741 | Irram Rao Md Inc | Clinic/Center | 22330 Hawthorne Blvd, Suite 207, Torrance, CA 90505-2536 | 2011-07-18 |
1457651457 | Rebecca Schraner-klinenberg | Speech-Language Pathologist | 22330 Hawthorne Blvd, Suite 204, Torrance, CA 90505-2536 | 2010-10-25 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780229260 | Sleep Apnea Team LLC | Clinic/Center | 2785 Pacific Coast Hwy Ste. E #197, Torrance, CA 90505 | 2019-11-08 |
1811469349 | Laura Anne Bloomberg | Marriage & Family Therapist | 2790 Sky Park Drive, Suite 215, Torrance, CA 90505 | 2018-12-21 |
1629544234 | Doroty O.d.s. Devalon | Physician Assistant | 23530 Hawthorne Boulevard Building 1, Suite 290, Torrance, CA 90505 | 2018-10-22 |
1790270486 | Juste Karvelyte | Dentist | 3500 Lomita Blvd Ste 201, Torrance, CA 90505 | 2018-06-26 |
1023507324 | Robert De Leon | Physician Assistant | 23530 Hawthorne Blvd Ste 290, Torrance, CA 90505 | 2018-05-02 |
1376052274 | Regents of The University of California | Durable Medical Equipment & Medical Supplies | 3500 Lomita Bvld, Suite 300, Torrance, CA 90505 | 2017-09-22 |
1649796038 | Chan & Huang Dental Partnership | Dentist | 3640 Lomita Blvd., #208, Torrance, CA 90505 | 2017-08-17 |
1093238370 | Family Acupuncture, Inc. | Specialist/Technologist, Other | 2820 Sepulveda Blvd.ste.a, Torrance, CA 90505 | 2017-07-19 |
1629518535 | J Lee Acupuncture | Acupuncturist | 24248 Crenshaw Blvd. #106, Torrance, CA 90505 | 2017-02-27 |
1770932360 | Maha Hanna Dds Inc | Dentist | 3710 Pacific Coast Hwy, Ste 101, Torrance, CA 90505 | 2016-06-06 |
Find all providers in zip 90505 |
Taxonomy Code | 261QM2500X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Medical Specialty |
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1659992527 | South Bay Neurology Medical Corporation | Clinic/Center | 3655 Lomita Blvd Ste 302, Torrance, CA 90505-1919 | 2020-05-02 |
1861949968 | Timothy J Hunt, Md, Inc. | Clinic/Center | 3475 Torrance Blvd, Suite F, Torrance, CA 90503-5800 | 2016-09-06 |
1245693100 | Sbps Aesthetic Institute, LLC | Clinic/Center | 3440 Lomita Blvd, Suite 100, Torrance, CA 90505-4801 | 2016-03-29 |
1538562343 | Ramin M. Roohipour, Md, Inc | Clinic/Center | 3400 Lomita Blvd, Suite 200, Torrance, CA 90505-4909 | 2014-10-07 |
1215366455 | Southern California Center for Anti Aging, Inc. | Clinic/Center | 23823 Hawthorne Blvd, Torrance, CA 90505-5907 | 2013-11-07 |
1790025492 | Hosayn Khaleeli, Md Inc. | Clinic/Center | 2245 Sepulveda Blvd, Torrance, CA 90501-5302 | 2013-02-18 |
1265798276 | David M. Duffy, Md Inc | Clinic/Center | 4201 Torrance Blvd, Ste 710, Torrance, CA 90503-4504 | 2012-04-03 |
1104102151 | Urology of Southbay Inc. | Clinic/Center | 4305 Torrance Blvd, Ste 500, Torrance, CA 90503-4409 | 2011-10-21 |
1235427741 | Irram Rao Md Inc | Clinic/Center | 22330 Hawthorne Blvd, Suite 207, Torrance, CA 90505-2536 | 2011-07-18 |
1659675072 | Brain Md Inc | Clinic/Center | 22617 Hawthorne Blvd, Torrance, CA 90505-2510 | 2010-12-28 |
Find all providers in TORRANCE |
Please comment or provide details below to improve the information on REVIVE WELLNESS CENTER.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.