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Contact Information

PACIFIC REJUVENATION MEDICAL, A PROFESSIONAL CORP
7230 MEDICAL CENTER DRIVE
SUITE 302
WEST HILLS, CA91307
 Phone: 818-518-5980
 Fax: 818-337-2049
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

208D00000X 99 Physician/Undefined Physician type[6]
 

Acupuncturist

171100000X
 

Chiropractor - Nutrition

111NN1001X 35 Chiropractic
 

Physician Assistant

363A00000X 97 Physician Assistant
 

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for PACIFIC REJUVENATION MEDICAL, A PROFESSIONAL CORP

NPI # 1528348620
LBN Legal business name PACIFIC REJUVENATION MEDICAL, A PROFESSIONAL CORP
Authorized official GLEN FARKAS - (MEDICAL DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 08/19/2011
Last updated 08/19/2011 - About 15 years ago
Identifiers
CA License # AC8403
CA License # DC24805
CA License # G56249
CA License # PA17921
CA License # PSY22296
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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