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

Revive Rejuvenation Center Anti Aging Regenerative Center Inc

Organization Clinic/Center · NPI 1588166094

Revive Rejuvenation Center Anti Aging Regenerative Center Inc is a Clinic/Center in LA Jolla, California. Registered with an NPI since 2018.

In the registry since
2018
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

7509 Draper Ave Ste A
LA Jolla, CA 92037-4857
Phone: (858) 352-6200
Fax: (858) 362-7555
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinic/Center (primary) Taxonomy 261Q00000X

Record details

NPI number1588166094
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michelle Gutierrez — Credentialing Specialist · (619) 501-6278
NPI enumeratedMarch 1, 2018
Last updated in NPPESMarch 21, 2018
Mailing address7509 Draper Ave, La Jolla, CA 92037-4862

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