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

Vida Revival Medical Corporation

Organization Primary Care Clinic/Center · NPI 1780560870

Vida Revival Medical Corporation is a Primary Care Clinic/Center in Thousand Oaks, California. Registered with an NPI since 2025.

In the registry since
2025

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

Primary Care Clinic/Center (primary) Taxonomy 261QP2300X

Record details

NPI number1780560870
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Diana Alavi — Md/ Ceo · (818) 232-8452
NPI enumeratedAugust 13, 2025
Last updated in NPPESAugust 13, 2025
Certification dateAugust 13, 2025
Mailing address3180 Willow Ln Ste 114, Thousand Oaks, CA 91361-4984

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