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

Revital Ahl

Individual provider Physician Assistant · NPI 1538769062

Revital Ahl is a Physician Assistant in Encino, California. Qualified in 2020, 6 years ago. Accepts Medicare assignment. Licensed in California.

Years since qualifying
6
Licensed in
CA
In the registry since
2020
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Practice location Address checks out

18141 Medley Dr
Encino, CA 91316-4447
Phone: (818) 422-4077
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 58759 (CA)

Record details

NPI number1538769062
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedOctober 26, 2020
Last updated in NPPESOctober 26, 2020
Certification dateOctober 26, 2020
Mailing address18141 Medley Dr, Encino, CA 91316-4447

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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