Restorix Medical Group PLLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

OP60152113 Issued in WA

Legal business name

RESTORIX MEDICAL GROUP PLLC

Practice address

1515 116TH Ave NE
Suite 300
Bellevue, WA 98004-3811

Phone

(425) 313-4800

Fax

(425) 391-1689

NPI assigned

Jun 9, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

John Fallou

Title

Ceo

Phone

(425) 688-3734

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1276041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350518400000",
    "number": "1184944332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190",
            "address_2": "#210",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980090190",
            "telephone_number": "425-688-3730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 116TH AVE NE",
            "address_2": "SUITE 300",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043811",
            "telephone_number": "425-313-4800",
            "fax_number": "425-391-1689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORIX MEDICAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-09",
        "last_updated": "2012-10-18",
        "status": "A",
        "authorized_official_last_name": "FALLOU",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "425-688-3734"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "WA",
            "license": "OP60152113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.