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

Revive Medical of San Diego

Organization General Practice Physician · NPI 1114484573

Revive Medical of San Diego is a General Practice Physician in San Diego, California. Registered with an NPI since 2019.

In the registry since
2019

Practice location Address checks out

7220 Trade St Ste 209
San Diego, CA 92121-2326
Phone: (858) 800-1006
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X

Record details

NPI number1114484573
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kevin Brown — Owner/Provider · (951) 440-1652
NPI enumeratedFebruary 21, 2019
Last updated in NPPESFebruary 21, 2019
Mailing address7220 Trade St Ste 209, San Diego, CA 92121-2326

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