Organization
REGENERATIVE MEDICAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL LEIBOVICI MD (OWNER)
(757) 373-8438
Entity
Organization
Contact information
Practice address
99 N LA CIENEGA BLVD STE 303, BEVERLY HILLS, CA 90211-2283
(757) 373-8438
Mailing address
99 N LA CIENEGA BLVD STE 303, BEVERLY HILLS, CA 90211-2283
(757) 373-8438
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C55251
STATE LICENSE
CA
Enumeration date
09/15/2021
Last updated
09/15/2021
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