Organization
REVIVE MEDSPA
Active
Organization
REVIVE MEDSPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VISHAL VERMA MD (OWNER)
(619) 293-7233
Entity
Organization
Contact information
Practice address
1425 FRAZEE RD, SAN DIEGO, CA 92108-4347
(619) 293-7233
Mailing address
1425 FRAZEE RD, SAN DIEGO, CA 92108-4347
(619) 293-7233
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
05/01/2025
Last updated
05/01/2025
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