Vida Revival Medical Corporation

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

VIDA REVIVAL MEDICAL CORPORATION

Practice address

3180 Willow LN Ste 114
Thousand Oaks, CA 91361-4984

Phone

(818) 232-8432

Fax

(818) 232-8433

NPI assigned

Aug 13, 2025

Organization subpart

No

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

Authorized official

Name

Dr. Diana Alavi, MD/ CEONPI 1700276680

Title

MD/ Ceo

Phone

(818) 232-8452

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.

• Diana Alavi

  • Internal Medicine Physician
  • Thousand Oaks, CA
  • NPI 1700276680
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1755043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755043200000",
    "number": "1780560870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3180 WILLOW LN STE 114",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913614984",
            "telephone_number": "818-232-8432",
            "fax_number": "818-232-8433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3180 WILLOW LN STE 114",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913614984",
            "telephone_number": "818-232-8432",
            "fax_number": "818-232-8433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIDA REVIVAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-13",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A",
        "authorized_official_last_name": "ALAVI",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "MD/ CEO",
        "authorized_official_telephone_number": "818-232-8452",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD/ CEO"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Veroni Wooff
• Destiny Verrette
• Hadley Veselak, NP
• Vesper Healthcare, Inc. (Buena Vista Hospice)
• Vida Revival LLC
• Michelle Carino Viernes, MD, BSMT
• Vigilance Healthcare Inc.
• Vigilance Medical Corporation
• Kimberly Villa
• Village OB GYN Medical Group Inc

• Primary Care Clinic/Center in Thousand Oaks, CA
• Providers in Thousand Oaks, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2025; 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.