Provider Demographics
NPI:1851811822
Name:REVELCARE LLC
Entity Type:Organization
Organization Name:REVELCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHISH
Authorized Official - Middle Name:
Authorized Official - Last Name:GUPTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-515-1391
Mailing Address - Street 1:11040 BOLLINGER CANYON RD
Mailing Address - Street 2:STE 839
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94582
Mailing Address - Country:US
Mailing Address - Phone:844-438-5228
Mailing Address - Fax:844-820-7071
Practice Address - Street 1:11040 BOLLINGER CANYON RD
Practice Address - Street 2:STE 839
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94582
Practice Address - Country:US
Practice Address - Phone:844-438-5228
Practice Address - Fax:844-820-7071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-21
Last Update Date:2017-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty