Organization
REJUVENATION SURGICENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SID KAMRAVA M.D. (CEO)
(818) 783-5050
Entity
Organization
Contact information
Practice address
17525 VENTURA BLVD, 101, ENCINO, CA 91316-3843
(818) 783-5050
(818) 783-5059
Mailing address
17525 VENTURA BLVD, 101, ENCINO, CA 91316-3843
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
11/04/2013
Last updated
11/04/2013
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