Pacific Rejuvenation Medical, A Professional Corp.
Non-pharmacy Dispensing Site
6310 San Vicente Blvd, Suite 220, Los Angeles
California, 90048-5426
818-518-5980 818-337-2049
Pacific Rejuvenation Medical, A Professional Corp. is a Non-pharmacy Dispensing Site in Los Angeles, California. This organization is also known as sub part of Pacific Rejuvenation Medical, A Professional Corp.. It is located at 6310 San Vicente Blvd, Suite 220, Los Angeles and it's customer support contact number is 818-518-5980. The authorized person of Pacific Rejuvenation Medical, A Professional Corp. is Dr. Lynn J. Goodloe, M.D. who is Medical Director of the pharmacy and his contact number is 818-518-5980. Active license number of Pacific Rejuvenation Medical, A Professional Corp. is G44674 for Non-pharmacy Dispensing Site in California.
Pacific Rejuvenation Medical, A Professional Corp. is a site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)
Pharmacy Details:
Pacific Rejuvenation Medical, A Professional Corp. type, location, contact phone number and fax are as below. Patients can directly walkin to the pharmacy or can call on the below given customer support phone number for enquiries.
| Name: | Pacific Rejuvenation Medical, A Professional Corp. |
| Type: | Non-pharmacy Dispensing Site |
| Location: | 6310 San Vicente Blvd, Suite 220, Los Angeles,
California, 90048-5426 |
| Phone: | 818-518-5980 |
| Fax: | 818-337-2049 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this pharmacy is as below. Person's position and contact details are also mentioned below.
| Name: | Dr. Lynn J. Goodloe |
| Credentials: | M.D. |
| Position: | Medical Director |
| Contact Number: | 818-518-5980 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given pharmacy are as mentioned below.
| NPI Number: | 1023428521 |
| Parent Organization: | Pacific Rejuvenation Medical, A Professional Corp. |
| NPI Enumeration Date: | 06 May, 2014 |
| NPI Last Update On: | 05 Oct, 2015 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Pacific Rejuvenation Medical, A Professional Corp. are as mentioned below.
| Specialization | License Number | State | Status | |
| Non-pharmacy Dispensing Site | G44674 | California | Primary | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 2980 N Beverly Glen Cir, Suite 100
Los Angeles, California |
| Zip: | 90077-1726 |
| Phone Number: | 310-943-4180 |
| Fax Number: | 888-431-8819 |
Patients can reach Pacific Rejuvenation Medical, A Professional Corp. at
6310 San Vicente Blvd, Suite 220, Los Angeles, California or can
call on customer care at 818-518-5980.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.