Healthcare Provider Details

I. General information

NPI: 1598013930
Provider Name (Legal Business Name): REVEAL DIAGNOSTICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2012
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

490 POST ST SUITE 301
SAN FRANCISCO CA
94102-1401
US

IV. Provider business mailing address

4217 PIEDMONT AVE SUITE B
OAKLAND CA
94611
US

V. Phone/Fax

Practice location:
  • Phone: 415-837-5990
  • Fax: 415-358-9633
Mailing address:
  • Phone: 415-837-5990
  • Fax: 888-808-6160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: AIMEE KNIGHT
Title or Position: PRESIDENT
Credential:
Phone: 415-837-5990