Revivist Md Inc
ActiveCalifornia license 556252
License
- Licensed by
- Medical Board of California
- License number
- 556252
- Status
- Active (Current)
- First issued
- August 16, 2023
- Expires
- August 31, 2027
- Entity type
- Organization
Classifications
- Fictitious Name Permit Physicians & Surgeons
More from the license record
- License type code
- 8008
Contact
8044 Camino Montego
Carlsbad, CA 92009-9542
Carlsbad, CA 92009-9542
San Diego County