Organization
PACIFIC REJUVENATION MEDICAL, A PROFESSIONAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLEN FARKAS M.D. (MEDICAL DIRECTOR)
(818) 610-9360
Entity
Organization
Contact information
Practice address
7230 MEDICAL CENTER DRIVE, SUITE 302, WEST HILLS, CA 91307
(818) 518-5980
(818) 337-2049
Mailing address
7230 MEDICAL CENTER DRIVE, SUITE 302, WEST HILLS, CA 91307
(818) 518-5980
(818) 337-2049
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PSY22296
CA
111NN1001X
Nutrition Chiropractor
DC24805
CA
171100000X
Acupuncturist
AC8403
CA
208D00000X
General Practice Physician
Primary
G56249
CA
363A00000X
Physician Assistant
PA17921
CA
Other
Enumeration date
08/19/2011
Last updated
08/19/2011
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