Restore Medical

Primary specialty

Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X

Legal business name

RESTORE MEDICAL

Practice address

16530 Ventura Blvd
Suite 200
Encino, CA 91436-4554

Phone

(954) 641-5366

NPI assigned

Jun 21, 2016

Organization subpart

No

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

Authorized official

Name

Eric Leon

Title

Coo

Phone

(954) 641-5366

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1466467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466467200000",
    "number": "1619327640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16530 VENTURA BLVD",
            "address_2": "SUITE 200",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914364554",
            "telephone_number": "954-641-5366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16530 VENTURA BLVD",
            "address_2": "SUITE 200",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914364554",
            "telephone_number": "954-641-5366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORE MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-21",
        "last_updated": "2016-06-21",
        "status": "A",
        "authorized_official_last_name": "LEON",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "954-641-5366"
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reliance Wound Care
• Rene Ghotanian DDS PC
• Veronica Renov, MD
• Renova Home Health Inc
• Veronica Resendiz
• Restore Medical Group, a Professional Corporation
• Retina Institute of California Medical Group
• Retina Los Angeles
• Revivacare Mobile
• Revupmd

• Addiction Medicine (Internal Medicine) Physician in Encino, CA
• Providers in Encino, CA by specialty
• Addiction Medicine (Internal Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2016; 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.