Prima Restorative and Wellness

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

Legal business name

PRIMA RESTORATIVE AND WELLNESS

Practice address

309 W Broadway
Glendale, CA 91204-1301

Phone

(310) 993-9691

NPI assigned

Nov 18, 2025

Organization subpart

No

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

Authorized official

Name

Anthony Ryan Miguel Aguirre, MD

Title

Ceo

Phone

(310) 993-9691

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1763424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763424000000",
    "number": "1194685479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 W BROADWAY",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912041301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 W BROADWAY",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912041301",
            "telephone_number": "310-993-9691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMA RESTORATIVE AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-18",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A",
        "authorized_official_last_name": "AGUIRRE",
        "authorized_official_first_name": "ANTHONY RYAN MIGUEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-993-9691",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Geriatric Medicine (Family Medicine) Physician in Glendale, CA
• Providers in Glendale, CA by specialty
• Geriatric Medicine (Family Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2025; 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.