AGEREVERSALMD.COM A PROFESSIONAL CORPORATION

LA JOLLA, CA
NPI1194450023
Entity TypeOrganization
Authorized ContactPHILLIP MARK MILGRAM
CEO
858-776-0544
Organization Subpart ?No
Primary Taxonomy251K00000X Public Health or Welfare
Additional Taxonomies207VG0400X Obstetrics & Gynecology, Gynecology
261QP2300X Clinic/Center, Primary Care
261QP3300X Clinic/Center, Pain
Enumeration Date2022-07-24
Last Update Date2022-07-24
Business Address
AGEREVERSALMD.COM A PROFESSIONAL CORPORATION
3252 HOLIDAY CT STE 211
LA JOLLA, CA 92037-0027
Phone number: 858-776-0544
Mailing Address
AGEREVERSALMD.COM A PROFESSIONAL CORPORATION
444 N EL CAMINO REAL SPC 123
ENCINITAS, CA 92024-1317
Phone number: 858-776-0544