REVIVEX HEALTHCARE INC (NPI# 1083087613) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083087613 |
| Entity Type | Organization |
| Organization Name | REVIVEX HEALTHCARE INC |
| Other Organization Name | PACIFIC PAIN & WELLNESS GROUP |
| Practice Address |
23150 Crenshaw Blvd Ste 100 Torrance CA 90505-3025 |
| Mailing Address |
2980 N Beverly Glen Cir Suite 100 Los Angeles CA 90077-1726 |
| Practice Telephone | 3104377399 |
| Practice Fax Number | 8884318819 |
| Mailing Telephone | 3109434180 |
| Mailing Fax Number | 8884318819 |
| Enumeration Date | 2015-11-04 |
| Last Update Date | 2019-02-28 |
| Authorized Official Name | KARTIK ANANTH (OWNER) |
| Authorized Official Telephone | 3109434180 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | A109016 | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2155100 | 01 |
| Other Name | Type Code |
|---|---|
| Pacific Pain & Wellness Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174800452 | Revivex Healthcare Inc | Pain Medicine | 23510 Crenshaw Blvd Ste 100, Torrance, CA 90505-5203 | 2011-11-15 |
| Street Address |
23150 CRENSHAW BLVD STE 100 |
| City | TORRANCE |
| State | CA |
| Zip Code | 90505-3025 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821279423 | Kartik Ananth | Psychiatry & Neurology | 23150 Crenshaw Blvd Ste 100, Torrance, CA 90505-3025 | 2007-11-25 |
| 1457582140 | Gelareh Solomon | Psychologist | 23150 Crenshaw Blvd Ste 100, Torrance, CA 90505-3025 | 2009-07-29 |
| 1083888069 | Reuben Kuan-chun Chen | Physical Medicine & Rehabilitation | 23150 Crenshaw Blvd Ste 100, Torrance, CA 90505-3025 | 2008-04-21 |
| 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 | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508270943 | Gs Medical Center, Inc. | Non-Pharmacy Dispensing Site | 2421 W 205th St, Suite D107, Torrance, CA 90501-1468 | 2014-06-13 |
| 1205192291 | Torrance Family and Urgent Care Inc | Non-Pharmacy Dispensing Site | 2573 Pacific Coast Hwy, Suite B, Torrance, CA 90505-7949 | 2012-04-04 |
| 1902280399 | Peter B. Shin, M.d., Inc. | Non-Pharmacy Dispensing Site | 23326 Hawthorne Blvd, Suite 140, Torrance, CA 90505-3725 | 2015-07-15 |
| 1922418870 | Kenneth K. Park, M.d., Inc. | Non-Pharmacy Dispensing Site | 23456 Hawthorne Blvd, Suite 300, Torrance, CA 90505-4716 | 2014-04-30 |
| 1801131180 | Sharp Treatment of South Bay, Inc | Non-Pharmacy Dispensing Site | 2557 Pacific Coast Hwy, Suite A, Torrance, CA 90505-7035 | 2012-11-28 |
| 1104184662 | West Torrance Podiatrists Group Inc | Non-Pharmacy Dispensing Site | 3400 Lomita Blvd, Suite 403, Torrance, CA 90505-4909 | 2012-05-02 |
| 1699050344 | Tiffany Rogers, Md, Mpt, Inc. | Non-Pharmacy Dispensing Site | 23456 Hawthorne Blvd, Suite 300, Torrance, CA 90505-4716 | 2011-10-13 |
| 1326337270 | Coastal View Gastroenterology of South Bay | Non-Pharmacy Dispensing Site | 3440 Lomita Blvd, Suite 420, Torrance, CA 90505-4801 | 2011-03-31 |
| 1083919831 | Peter S. Borden, M.d., A Medical Corporation | Non-Pharmacy Dispensing Site | 23456 Hawthorne Blvd, Suite 200, Torrance, CA 90505-4716 | 2011-01-25 |
| 1508175761 | Western Medical Group, Inc. | Non-Pharmacy Dispensing Site | 21081 S Western Ave, Suite 150, Torrance, CA 90501-1703 | 2010-10-05 |
| Find all providers in TORRANCE | ||||
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| 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.