Healthcare Provider Details

I. General information

NPI: 1699686899
Provider Name (Legal Business Name): CLARIOVA REVENUE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

458 BOYNTON AVE APT A2
SAN JOSE CA
95117-1426
US

IV. Provider business mailing address

458 BOYNTON AVE APT A2
SAN JOSE CA
95117-1426
US

V. Phone/Fax

Practice location:
  • Phone: 717-268-9132
  • Fax: 717-268-9132
Mailing address:
  • Phone: 717-268-9132
  • Fax: 717-268-9132

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SARPREET SINGH
Title or Position: CEO
Credential:
Phone: 717-268-9133