# REVIVE PAIN & SPINE CENTER, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285460220
- **Authorized official:** DR. AKBAR KHAN DO (OWNER)
- **Authorized official phone:** (586) 615-4250

## Contact information

- **Practice address:** 3609 MISSION AVE STE D, CARMICHAEL, CA 95608-2955
- **Practice address phone:** (530) 650-8333
- **Practice address fax:** (530) 650-8388
- **Mailing address:** 3609 MISSION AVE STE D, CARMICHAEL, CA 95608-2955
- **Mailing address phone:** (530) 650-8333
- **Mailing address fax:** (530) 650-8388

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | Yes |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/09/2024
- **Last updated:** 09/09/2024