Healthcare Provider Details
I. General information
NPI: 1851709984
Provider Name (Legal Business Name): REVEAL DIAGNOSTICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/01/2014
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6080 HELLYER AVE SUITE 175
SAN JOSE CA
95138-1052
US
IV. Provider business mailing address
490 POST ST SUITE 301
SAN FRANCISCO CA
94102-1401
US
V. Phone/Fax
- Phone: 888-973-8325
- Fax: 888-808-6160
- Phone: 888-973-8325
- Fax: 888-808-6160
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QD0000X |
| Taxonomy | Dental Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085B0100X |
| Taxonomy | Body Imaging Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR0200X |
| Taxonomy | Radiology Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AIMEE
KNIGHT
Title or Position: PRESIDENT
Credential:
Phone: 415-837-5990