Revive,a Medical Corporation

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

REVIVE,A MEDICAL CORPORATION

Practice address

4310 Tradewinds Dr Ste 300
Oxnard, CA 93035-1410

Phone

(805) 889-2511

Fax

(866) 242-5109

NPI assigned

Oct 7, 2019

Organization subpart

No

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

Authorized official

Name

Paul S Weinberg, MD

Title

Medical Director

Phone

(907) 442-3321

Specialties & licenses 1

Addresses

Other names 1

• IV Revive Plus Doing business as

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

{
    "created_epoch": "1570406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570406400000",
    "number": "1659912905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4310 TRADEWINDS DR STE 300",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930351410",
            "telephone_number": "661-993-8941",
            "fax_number": "866-242-5109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4310 TRADEWINDS DR STE 300",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930351410",
            "telephone_number": "805-889-2511",
            "fax_number": "866-242-5109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE,A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-07",
        "last_updated": "2019-10-07",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "907-442-3321",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IV Revive Plus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ivan Alexander Rendon
• Renewed Hope Radiation Oncology, Inc.
• Gricet Renteria
• Jodee Quirk Renteria, MA
• Reseda Prosthetics, Inc.
• Maria Del Carmen Reyes Camarillo
• Desiree Reyes
• Elise Dionisia Reyes
• Jazzlyn Guadalupe Reyes
• Jennifer M Reyes

• Family Medicine Physician in Oxnard, CA
• Providers in Oxnard, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.