# STEPHEN M. DAQUINO, DO; INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Revivify Restorative Medicine, Strive Sports & Family Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003164385
- **Authorized official:** STEPHEN M DAQUINO DO (MEDICAL DIRECTOR)
- **Authorized official phone:** (858) 429-0099

## Contact information

- **Practice address:** 16445 BERNARDO CENTER DR, SAN DIEGO, CA 92128-2523
- **Practice address phone:** (858) 429-0099
- **Practice address fax:** (858) 676-1172
- **Mailing address:** 16445 BERNARDO CENTER DR, SAN DIEGO, CA 92128-2523
- **Mailing address phone:** (858) 429-0099
- **Mailing address fax:** (866) 266-8027

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | 20A8442 | CA | Yes |

## Other

- **Enumeration date:** 08/17/2012
- **Last updated:** 07/29/2020