Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Agereversalmd Com a Professional Corporation

Organization Gynecology Physician · NPI 1194450023

Agereversalmd Com a Professional Corporation is a Gynecology Physician in LA Jolla, California. Works from 2 locations. Registered with an NPI since 2022.

In the registry since
2022
Specialties on file
4

Practice location Address checks out

3252 Holiday Ct Ste 211
LA Jolla, CA 92037-0027
Phone: (858) 776-0544
Fax: (760) 692-4411
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1207 Carlsbad Village Dr Ste Q, Carlsbad, CA 92008-1958 — (760) 944-9200

Specialties & licences

Public Health or Welfare Agency (primary) Taxonomy 251K00000X
Gynecology Physician Taxonomy 207VG0400X
Primary Care Clinic/Center Taxonomy 261QP2300X
Pain Clinic/Center Taxonomy 261QP3300X

Record details

NPI number1194450023
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Phillip Milgram — Ceo · (858) 776-0544
NPI enumeratedJuly 24, 2022
Last updated in NPPESJuly 24, 2022
Certification dateJuly 24, 2022
Mailing address444 N El Camino Real Spc 123, Encinitas, CA 92024-1317

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