REVIVE MEDICAL GROUP CA PC

MOUNT SHASTA, CA
NPI1518724624
Entity TypeOrganization
Authorized ContactOMAR ZIYADEH
CEO/Manager
203-430-1321
Organization Subpart ?No
Primary Taxonomy2084P0800X Psychiatry & Neurology, Psychiatry
Enumeration Date2024-03-05
Last Update Date2024-03-05
Business Address
REVIVE MEDICAL GROUP CA PC
914 PINE ST
MOUNT SHASTA, CA 96067-2143
Phone number: 203-430-1321
Mailing Address
REVIVE MEDICAL GROUP CA PC
81 ROANOKE AVE
FAIRFIELD, CT 06824-6124
Phone number: 203-430-1321
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