Revital Physical Therapy LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

REVITAL PHYSICAL THERAPY LLC

Practice address

32206 Deborah Dr
Union City, CA 94587-4724

Phone

(510) 399-5548

NPI assigned

Jan 31, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Navjot TatlahNPI 1174895544

Title

Owner

Phone

(510) 399-5548

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Navjot Tatlah

  • Physical Therapist
  • Union City, CA
  • NPI 1174895544
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1643587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689811200000",
    "number": "1619620531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32206 DEBORAH DR",
            "city": "UNION CITY",
            "state": "CA",
            "postal_code": "945874724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32206 DEBORAH DR",
            "city": "UNION CITY",
            "state": "CA",
            "postal_code": "945874724",
            "telephone_number": "510-399-5548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVITAL PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-31",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A",
        "authorized_official_last_name": "TATLAH",
        "authorized_official_first_name": "NAVJOT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "510-399-5548"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Reed
• Gianina Casareno Reibling, LMFT, RDH
• Brenda L Reida, LPCC
• Renegade Nutrition LLC
• Anthony Paul Ret, M.D.
• Revive Roots Physical Therapy
• Almarose Revives, SLPA, ATS
• Shirley Reyes Hernandez
• Edwin Paa Reyes, DMD
• Gabrielle Afan Reyes, PHARMD

• Physical Therapy Clinic/Center in Union City, CA
• Providers in Union City, CA by specialty
• Physical Therapy Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.