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General NPI Number Information
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NPI Number | 1710435144
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Entity Type | Organization
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Legal Business Name | RESTORING HEALTH MEDICAL INSTITUTE, INC.
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Dates
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Enumeration Date | 09/14/2016
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Last Update Date | 09/14/2016
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Provider Practice Location Address
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Address Line | 11540 SANTA MONICA BLVD SUITE 204
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City | LOS ANGELES
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State | CA
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Zip | 90025
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Country | US
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Telephone | 888-774-3254
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Fax |
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Provider Business Mailing Address
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Address Line | 11540 SANTA MONICA BLVD SUITE 204
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City | LOS ANGELES
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State | CA
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Zip | 90025
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Country | US
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Telephone | 888-774-3254
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. DAVID MOOSSAZADEH
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Credential | D.O
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Telephone | 888-774-3254
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 20A11456
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License Number State | CA
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