OrganizationActive
Revitalize Life Center a PC
NPI 1679102248 · Internal Medicine Physician · Long Beach, CA
Provider details
- NPI number
- 1679102248
- Entity type
- Organization
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Ebony Foster, Billing Support(562) 457-6010
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(64/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 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
3939 Atlantic Ave Ste 100
Long Beach, CA 90807-3529
Phone: (562) 457-6010
Fax: (562) 424-5600
Street-level locationGet directions
Mailing address
3939 Atlantic Ave Ste 100
Long Beach, CA 90807-3529
Registry dates
- Enumerated
- 2020-04-06
- Last updated
- 2020-04-06
- Certified
- 2020-04-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.