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

Revitawound Incorporated

Organization Internal Medicine Physician · NPI 1538982533

Revitawound Incorporated is an Internal Medicine Physician in Burbank, California. Registered with an NPI since 2024.

In the registry since
2024

Practice location Address checks out

146 N San Fernando Blvd Ste 213
Burbank, CA 91502-1230
Phone: (562) 506-6577
Fax: (747) 877-8189
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X

Record details

NPI number1538982533
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jennifer Mata — Owner · (562) 506-6577
NPI enumeratedNovember 7, 2024
Last updated in NPPESNovember 19, 2024
Certification dateNovember 19, 2024
Mailing address146 N San Fernando Blvd Ste 213, Burbank, CA 91502-1230

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