Provider Demographics
NPI:1790672954
Name:LIVARA HEALTH MEDICAL GROUP PC
Entity type:Organization
Organization Name:LIVARA HEALTH MEDICAL GROUP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSING & CREDENTIALING SPECIALIS
Authorized Official - Prefix:
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CUARTAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:844-316-7979
Mailing Address - Street 1:7525 METROPOLITAN DR STE 36
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-4411
Mailing Address - Country:US
Mailing Address - Phone:619-275-7460
Mailing Address - Fax:866-813-1235
Practice Address - Street 1:6005 HIDDEN VALLEY RD STE 100
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92011-4223
Practice Address - Country:US
Practice Address - Phone:844-316-7979
Practice Address - Fax:866-813-1235
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LIVARA HEALTH MEDICAL GROUP PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-06-20
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty