| Revitalife Medical Center | |
|
14650 Aviation Blvd Hawthorne CA 90250-6668 | |
| (310) 545-1154 | |
| (310) 545-1132 |
| Full Name | Revitalife Medical Center |
|---|---|
| Speciality | Family Medicine |
| Location | 14650 Aviation Blvd, Hawthorne, California |
| Authorized Official Name and Position | Khoi Vu (MD) |
| Authorized Official Contact | 3105451154 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Revitalife Medical Center 14650 Aviation Blvd Hawthorne CA 90250-6668 Ph: (310) 545-1154 | Revitalife Medical Center 14650 Aviation Blvd Hawthorne CA 90250-6668 Ph: (310) 545-1154 |
| NPI Number | 1912759820 |
|---|---|
| Provider Enumeration Date | 04/03/2024 |
| Last Update Date | 04/03/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912759820 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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