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

Vida Revival LLC

Organization Internal Medicine Physician · NPI 1952115149

Vida Revival LLC is an Internal Medicine Physician in Thousand Oaks, California. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3180 Willow Ln Ste 114
Thousand Oaks, CA 91361-4984
Phone: (818) 232-8432
Fax: (818) 232-8433
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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 number1952115149
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Diana Alavi — Owner · (818) 232-8432
NPI enumeratedFebruary 6, 2025
Last updated in NPPESFebruary 6, 2025
Certification dateFebruary 6, 2025
Mailing address3180 Willow Ln Ste 114, Thousand Oaks, CA 91361-4984

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