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Organization
REVIVEX HEALTHCARE INC
Active
Organization
REVIVEX HEALTHCARE INC
Active
Other names
PACIFIC PAIN & WELLNESS GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KARTIK ANANTH MD (PRESIDENT)
(310) 437-7399
Entity
Organization
Contact information
Practice address
23510 CRENSHAW BLVD STE 100, TORRANCE, CA 90505-5203
(310) 437-7399
(310) 437-7398
Mailing address
23150 CRENSHAW BLVD STE 100, TORRANCE, CA 90505-3025
(310) 437-7399
(104) 377-3993
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
CA
208100000X
Physical Medicine & Rehabilitation Physician
—
CA
2084P0800X
Psychiatry Physician
—
CA
2084P2900X
Pain Medicine (Psychiatry & Neurology) Physician
Primary
—
CA
208VP0014X
Interventional Pain Medicine Physician
—
CA
Other
Enumeration date
11/15/2011
Last updated
03/22/2024
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