FUNCTIONAL RESTORATION MEDICAL CENTER, INC, (NPI# 1205937752) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205937752 |
| Entity Type | Organization |
| Organization Name | FUNCTIONAL RESTORATION MEDICAL CENTER, INC, |
| Other Organization Name | GARDEN GROVE IMAGING |
| Practice Address |
12828 Harbor Blvd Suite 200 Garden Grove CA 92840-5831 |
| Mailing Address |
9134 W Olympic Blvd Beverly Hills CA 90212-3540 |
| Practice Telephone | 7146208200 |
| Practice Fax Number | 7146208211 |
| Mailing Telephone | 3104321000 |
| Mailing Fax Number | 3104324321 |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. MOOSA HEIKALI (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 3104321000 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0200X |
Clinic/Center Specialization: Radiology |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| GARDEN GROVE IMAGING | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801987995 | Functional Restoration Medical Center, Inc | Clinic/Center | 375 W Central Ave, Brea, CA 92821-3025 | 2006-09-27 |
| 1205927399 | Functional Restoration Medical Center, Inc | Clinic/Center | 3513 Whittier Blvd, Los Angeles, CA 90023-1709 | 2006-09-27 |
| 1649371006 | Functional Restoration Medical Center, Inc | Clinic/Center | 110 S La Brea Ave, Suite 150, Inglewood, CA 90301-1768 | 2006-09-26 |
| 1861593345 | Functional Restoration Medical Center, Inc | Clinic/Center | 9134 W Olympic Blvd, Beverly Hills, CA 90212-3540 | 2006-09-26 |
| 1629179155 | Functional Restoration Medical Center, Inc | Clinic/Center | 1141 W Redondo Beach Blvd, Suite 105, Gardena, CA 90247-3586 | 2006-09-26 |
| 1063513455 | Functional Restoration Medical Center, Inc | Clinic/Center | 4316 Slauson Ave, Maywood, CA 90270-2838 | 2006-09-26 |
| 1396846762 | Functional Restoration Medical Center, Inc | Clinic/Center | 15825 Laguna Canyon Rd, Suite 101, Irvine, CA 92618-2125 | 2006-09-26 |
| 1689775025 | Functional Restoration Medical Center, Inc | Clinic/Center | 3640 Lomita Blvd, Suite 105, Torrance, CA 90505-3927 | 2006-09-26 |
| 1629179072 | Functional Restoration Medical Center, Inc | Clinic/Center | 1127 Wilshire Blvd, Suite 100, Los Angeles, CA 90017-3901 | 2006-09-26 |
| 1861593360 | Functional Restoration Medical Center, Inc | Clinic/Center | 11411 Brookshire Ave, Suite 101, Downey, CA 90241-5003 | 2006-09-26 |
| Street Address |
12828 HARBOR BLVD SUITE 200 |
| City | GARDEN GROVE |
| State | CA |
| Zip Code | 92840-5831 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003860867 | Young Sook Yun | Radiology | 12828 Harbor Blvd, #320, Garden Grove, CA 92840-2005 | 2006-05-19 |
| 1184046195 | Hyun K Kang | Podiatrist | 12828 Harbor Blvd, Suite 320, Garden Grove, CA 92844-5834 | 2014-01-09 |
| 1093087975 | Flowe Nursing Anesthesia, Inc. | Nurse Anesthetist, Certified Registered | 12828 Harbor Blvd, Ste 210, Garden Grove, CA 92840-5831 | 2012-02-07 |
| 1649599523 | Loo, Hsiao, & Tsai, A Professional Corporation | Dentist | 12828 Harbor Blvd, 350, Garden Grove, CA 92840-5831 | 2010-05-18 |
| 1437481603 | Advanced Anesthesia Associates Inc | Anesthesiology | 12828 Harbor Blvd, Suite 210, Garden Grove, CA 92840-5831 | 2010-02-12 |
| 1841486560 | Edward Medical Ipa, Inc. | Case Manager/Care Coordinator | 12828 Harbor Blvd, Suite 230, Garden Grove, CA 92840-5831 | 2007-09-16 |
| 1457445124 | Eddie C Pyune | Family Medicine | 12828 Harbor Blvd, Suite 230, Garden Grove, CA 92840-5831 | 2006-10-03 |
| 1275627986 | Edward Medical Group, Inc | Family Medicine | 12828 Harbor Blvd, Suite 230, Garden Grove, CA 92840-5831 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588283808 | Kimberly Gaeta | Behavioral Analyst | 123935 Lewis Street, Ste 202, Garden Grove, CA 92840 | 2020-04-16 |
| 1396397170 | Rosa Cortez | Behavior Technician | 12443 Lewis Street, #201, Garden Grove, CA 92840 | 2019-07-12 |
| 1376005934 | Sekboppa Sor | Nurse Practitioner | An Lanh Free Clinic, 10861 Acacia Pkwy., Garden Grove, CA 92840 | 2019-04-03 |
| 1346730116 | Vinh Le Tran | Pharmacist | 12666 Brookhurst St. Suite 110, Garden Grove, CA 92840 | 2018-05-16 |
| 1841715232 | Scott R. Blair | Physician Assistant | 12828 Harbor Blvd Ste 200, Garden Grove, CA 92840 | 2017-08-07 |
| 1881049492 | Carmen Keally | Dietitian, Registered | 12602 9th St, Garden Grove, CA 92840 | 2016-05-02 |
| 1548688732 | House Call Medical Associates, Inc. | Internal Medicine | 12865 Main St Ste 105, Garden Grove, CA 92840 | 2014-04-03 |
| 1851733059 | Carly Ann Wade | Marriage & Family Therapist | 12755 Brookhurst St. Ste 116, Garden Grove, CA 92840 | 2013-07-29 |
| 1003159864 | Priyal Shah Ohri | Dentist | 10602 Chapman Ave, Suite 200, Garden Grove, CA 92840 | 2013-03-30 |
| 1770853244 | Joseph Pham | Pharmacist | 12001 Euclid St., Garden Grove, CA 92840 | 2011-12-30 |
| Find all providers in zip 92840 | ||||
| Taxonomy Code | 261QR0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619142296 | United Medical Radiology Network | Clinic/Center | 12665 Garden Grove Blvd Ste 103, Garden Grove, CA 92843-1915 | 2008-04-24 |
| 1730279001 | United Medical Imaging Healthcare, Inc. | Clinic/Center | 12665 Garden Grove Blvd, Suite # 103, Garden Grove, CA 92843-1901 | 2006-10-14 |
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| 1780201012 | Whitsett Diagnostic Inc | Clinic/Center | 12444 Victory Blvd Ste 407, North Hollywood, CA 91606-3199 | 2020-07-02 |
| 1164049508 | Ohni Imaging Inc | Clinic/Center | 8631 W 3rd St # 945e, Los Angeles, CA 90048-5901 | 2020-07-01 |
| 1952924599 | Oracle Imaging Inc. | Clinic/Center | 6941 Brockton Ave, Riverside, CA 92506-3803 | 2020-05-18 |
| 1720625742 | F&m Radiology Medical Center Inc | Clinic/Center | 17779 Ventura Blvd # 100, Encino, CA 91316-3717 | 2019-12-09 |
| 1982240321 | United Care Foundation | Clinic/Center | 2233 Watt Ave Ste 120, Sacramento, CA 95825-0569 | 2019-11-20 |
| 1932744893 | Westcoast Radiology Associates Pllc | Clinic/Center | 4193 Flat Rock Dr Ste 200, Riverside, CA 92505-7113 | 2019-11-14 |
| 1518502087 | Ishraf Corporation | Clinic/Center | 5720 Stoneridge Mall Rd Ste 288, Pleasanton, CA 94588-2830 | 2019-11-08 |
| 1780227769 | Drs Concepts, Incorporated | Clinic/Center | 9335 Reseda Blvd. Suite 102, Northridge, CA 91324 | 2019-10-23 |
| 1538700588 | Central Valley Medical Imaging, LLC | Clinic/Center | 1125 E Spruce Ave Ste 103, Fresno, CA 93720-3385 | 2019-10-01 |
| 1700447497 | Ester A Hanna | Clinic/Center | 72650 Fred Waring Dr Ste 107, Palm Desert, CA 92260-5007 | 2019-06-24 |
| Find all providers with the same taxonomy | ||||
| City | GARDEN GROVE |
| Zip Code | 92840 |
Please comment or provide details below to improve the information on FUNCTIONAL RESTORATION MEDICAL CENTER, INC,.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.