Functional Restoration Medical Center, Inc,
NPI #1063513455 in Maywood, California
Provider Information
- NPI Number
- 1063513455
- Entity Type
- Organization
- Organization Name
- Functional Restoration Medical Center, Inc,
- Primary Specialty
- Clinic/Center - Radiology
- Enumeration Date
- Sep 26, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 4316 SLAUSON AVE
- City
- Maywood
- State
- California
- ZIP Code
- 90270-2838
- Phone
- (323) 771-9867
Authorized Official
- Name
- DR. MOOSA HEIKALI, M.D.
- Title
- MEDICAL DIRECTOR
- Phone
- (310) 432-1000
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Radiology — Radiology |
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