Revivamed Medical Corporation
NPI 1609061498 · Internal Medicine Physician · San Diego, CA
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Revivamed Medical Corporation is a Internal Medicine Physician organization in San Diego, CA (NPI 1609061498).
Provider details
- NPI number
- 1609061498
- Entity type
- Organization
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Roya Kohani, President(619) 232-3040
- License
- A50365 (CA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2007-09-13
- Last updated
- 2007-09-13
Frequently asked questions
- What is Revivamed Medical Corporation's NPI number?
- Revivamed Medical Corporation's National Provider Identifier (NPI) is 1609061498, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Revivamed Medical Corporation?
- Revivamed Medical Corporation is classified in the NPPES registry as Internal Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Revivamed Medical Corporation located?
- Revivamed Medical Corporation's practice location on file with NPPES is 711 4th Ave, San Diego, CA 92101-6970.
- What is Revivamed Medical Corporation's phone number?
- The practice phone number listed in the NPPES registry for Revivamed Medical Corporation is (619) 232-3040.
- Does Revivamed Medical Corporation accept Medicare?
- Revivamed Medical Corporation is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Revivamed Medical Corporation?
- The authorized official listed on Revivamed Medical Corporation's NPPES record is Roya Kohani, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Revivamed Medical Corporation's NPI active?
- Yes — Revivamed Medical Corporation's NPI (1609061498) is active in the NPPES registry as of the last update on 2007-09-13.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.