NPIMap

Organization Active NPI

Functional Restoration Medical Center, Inc,

  • Radiology Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1629179072
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
FUNCTIONAL RESTORATION MEDICAL CENTER, INC,
Practice address
1127 Wilshire Blvd
Suite 100
Los Angeles, CA 90017-3901
Phone
(213) 202-5785
Fax
(213) 202-5709
NPI assigned
Sep 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Moosa Heikali, M.D.
Title
Medical Director
Phone
(310) 432-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X Primary

Addresses

Primary practice location

1127 Wilshire Blvd
Suite 100
Los Angeles, CA 90017-3901

Mailing address

9134 W Olympic Blvd
Beverly Hills, CA 90212-3540
Phone (310) 432-1000

Other names 1

  • WILSHIRE OPEN MRI Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Functional Restoration Medical Center Inc17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629179072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9134 W OLYMPIC BLVD",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902123540",
            "telephone_number": "310-432-1000",
            "fax_number": "310-432-4321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1127 WILSHIRE BLVD",
            "address_2": "SUITE 100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900173901",
            "telephone_number": "213-202-5785",
            "fax_number": "213-202-5709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNCTIONAL RESTORATION MEDICAL CENTER, INC,",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HEIKALI",
        "authorized_official_first_name": "MOOSA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "310-432-1000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WILSHIRE OPEN MRI",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.