Restore Health Corp

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

RESTORE HEALTH CORP

Doing business as

MTM Pharmacy I

Practice address

12666 Brookhurst St
#110
Garden Grove, CA 92840-4866

Phone

(714) 705-6992

Fax

(714) 705-6988

NPI assigned

Dec 30, 2013

Last updated

Apr 8, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tina Tuyet Quach-Tran, PHARM DNPI 1124658471

Title

President/Ceo

Phone

(714) 705-6992

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• MTM PHARMACY I Doing business as

Medicare fee-for-service enrollment

Enrolled in CA5 enrollments

Enrollment records 5

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• MTM Pharma Inc

  dba Professional Pharmacy Santa Ana

  • Community/Retail Pharmacy
  • Santa Ana, CA
  • NPI 1659797421

  O20160418000856

  Same enrollment

Tax ID family

Restore Health Corp2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Restore Health Corp

  dba MTM Pharmacy I

  • Long Term Care Pharmacy
  • Garden Grove, CA
  • NPI 1215672613
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tina Tuyet Quach-Tran

  • Pharmacist
  • Huntington Beach, CA
  • NPI 1124658471
  Authorized official Same address or phone

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

{
    "created_epoch": "1388361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649376000000",
    "number": "1467873927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12666 BROOKHURST ST",
            "address_2": "#110",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928404866",
            "telephone_number": "714-705-6992",
            "fax_number": "714-705-6988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12666 BROOKHURST ST",
            "address_2": "#110",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928404866",
            "telephone_number": "714-705-6992",
            "fax_number": "714-705-6988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORE HEALTH CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-30",
        "last_updated": "2022-04-08",
        "certification_date": "2022-04-08",
        "status": "A",
        "authorized_official_last_name": "QUACH-TRAN",
        "authorized_official_first_name": "TINA TUYET",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "714-705-6992",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7217942",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY",
            "identifier": "PHY57946",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MTM PHARMACY I",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Noel Isaiah Renteria
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• Kiana Respicio
• Rest Analysis L.P.
• Restore Health Corp (MTM Pharmacy I)
• Retina Institute of California Medical Group, a California Medical Par (Acuity Eye Group)
• Brittnee J Reveles
• Patrick Revives
• Alfonso Rey
• Evelin Reyes Barbosa

• Community/Retail Pharmacy in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.