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Organization
REVITALIFE MEDICAL CENTER
Active
Organization
REVITALIFE MEDICAL CENTER
Active
Other names
Revitalife Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
KHOI VU (MD)
(310) 545-1154
Entity
Organization
Contact information
Practice address
14650 AVIATION BLVD, HAWTHORNE, CA 90250-6668
(310) 545-1154
(310) 545-1132
Mailing address
14650 AVIATION BLVD, HAWTHORNE, CA 90250-6668
(310) 545-1154
(310) 545-1132
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
04/03/2024
Last updated
04/03/2024
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