REVIVEX HEALTHCARE INC (NPI# 1174800452) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174800452 |
| Entity Type | Organization |
| Organization Name | REVIVEX HEALTHCARE INC |
| Other Organization Name | PACIFIC PAIN & WELLNESS GROUP |
| Practice Address |
23510 Crenshaw Blvd Ste 100 Torrance CA 90505-5203 |
| Mailing Address |
Po Box 3129 Torrance CA 90510-3129 |
| Practice Telephone | 3104377399 |
| Practice Fax Number | 3104377398 |
| Mailing Telephone | 3107923914 |
| Mailing Fax Number | 8558984055 |
| Enumeration Date | 2011-11-15 |
| Last Update Date | 2019-02-28 |
| Authorized Official Name | DR. KARTIK ANANTH (PRESIDENT) |
| Authorized Official Telephone | 3104377399 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
CA | Allopathic & Osteopathic Physicians | |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
CA | Behavioral Health & Social Service Providers | |
| N | 208100000X | Physical Medicine & Rehabilitation | CA | Allopathic & Osteopathic Physicians | |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
CA | Allopathic & Osteopathic Physicians | |
| Y | 2084P2900X |
Psychiatry & Neurology Specialization: Pain Medicine |
CA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| PACIFIC PAIN & WELLNESS GROUP | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083087613 | Revivex Healthcare Inc | Non-Pharmacy Dispensing Site | 23150 Crenshaw Blvd Ste 100, Torrance, CA 90505-3025 | 2015-11-04 |
| Street Address |
23510 CRENSHAW BLVD STE 100 |
| City | TORRANCE |
| State | CA |
| Zip Code | 90505-5203 |
| 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 | 2084P2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Pain Medicine |
| A neurologist, child neurologists or psychiatrist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Psychiatry and Neurology, 2007. http://www.abpn.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Psychiatry and Neurology. A subspecialty certificate was approved by ABMS in 1998. ACGME Accredited Residency Program Requirements: None. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073144762 | Integrated Neurology & Pain Management, PC | Psychiatry & Neurology | 155 Glen Cove Marina Rd E Ste 100, Vallejo, CA 94591-7284 | 2020-01-31 |
| 1700423704 | Estera Luminita Heller | Psychiatry & Neurology | 1510 W Whittier Blvd # 54, La Habra, CA 90631-3617 | 2019-12-09 |
| 1669965885 | California Centers for Psychiatric Wellness and Health | Psychiatry & Neurology | 1307 W 6th St Ste 105, Corona, CA 92882-1644 | 2018-06-12 |
| 1396004594 | Hirsh Kaveeshvar | Psychiatry & Neurology | 23861 Mcbean Pkwy Ste B18, Valencia, CA 91355 | 2012-05-08 |
| 1548450448 | Aimee C Chagnon | Psychiatry & Neurology | 357 Perkins St, Suite 206, Sonoma, CA 95476-6826 | 2007-07-26 |
| 1902005713 | James David Weiss | Psychiatry & Neurology | 624 Frederick Street, Santa Cruz, CA 95062 | 2007-07-12 |
| 1467672485 | Fadi Alhatem | Psychiatry & Neurology | 250 N Robertson Blvd Ste 505, Beverly Hills, CA 90211 | 2007-05-01 |
| 1366510489 | Michael Harvey Moskowitz | Psychiatry & Neurology | 3 Harbor Dr, Suite 115, Sausalito, CA 94965-1454 | 2006-11-30 |
| 1497768170 | Thomas Benedict Bryan | Psychiatry & Neurology | 3351 M Street, Ste 120, Merced, CA 95348 | 2006-08-14 |
| 1235118068 | California Headache and Pain Specialist, Inc. | Psychiatry & Neurology | 420 W. Las Tunas Dr., San Gabriel, CA 91776 | 2006-01-11 |
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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.