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Agereversalmd.Com A Professional Corporation

Public Health or Welfare Agency in La Jolla, CA · enumerated 2022 · authorized official Phillip Milgram, Ceo.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1194450023

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Registry record

Entity type Organization (Type 2)
Legal business name Agereversalmd.Com A Professional Corporation
Practice address 3252 Holiday Ct Ste 211, La Jolla, CA, 92037
Phone (858) 776-0544
Fax (760) 692-4411
Enumeration date Jul 24, 2022
Last updated in NPPES Jul 24, 2022

Taxonomy & classification

207VG0400X Gynecology Physician Allopathic & Osteopathic Physicians Secondary
251K00000X Public Health or Welfare Agency Agencies Primary
261QP2300X Primary Care Clinic/Center Ambulatory Health Care Facilities Secondary
261QP3300X Pain Clinic/Center Ambulatory Health Care Facilities Secondary

Authorized official

Name Phillip Milgram
Title Ceo
Phone (858) 776-0544

Other identifiers

Identifier Type State Issuer
1285737569 Other CA INDIVIDUAL NPI

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2022-07-24. Verify at npiregistry.cms.hhs.gov.
Where is Agereversalmd.Com A Professional Corporation located?
The practice location on file with NPPES is in La Jolla, CA.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2022-07-24.