Organization
REVIVE MEDICAL OF SAN DIEGO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN BROWN DC (OWNER/PROVIDER)
(951) 440-1652
Entity
Organization
Contact information
Practice address
7220 TRADE ST STE 209, SAN DIEGO, CA 92121-2326
(858) 800-1006
Mailing address
7220 TRADE ST STE 209, SAN DIEGO, CA 92121-2326
(858) 800-1006
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
02/21/2019
Last updated
02/21/2019
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