Healthcare Provider Details
I. General information
NPI: 1851220859
Provider Name (Legal Business Name): NOREVX MEDICAL PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/15/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
25044 PEACHLAND AVE STE 209
NEWHALL CA
91321-5751
US
IV. Provider business mailing address
25044 PEACHLAND AVE STE 110
NEWHALL CA
91321-5730
US
V. Phone/Fax
- Phone: 409-370-8507
- Fax:
- Phone: 409-370-8507
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
IZUCHUKWU
OKPARA
Title or Position: OWNER
Credential: MD
Phone: 409-370-8507