California Functional Internal Medicine Clinic LLC
NPI #1609633049 in Lake Forest, California
Provider Information
- NPI Number
- 1609633049
- Entity Type
- Organization
- Organization Name
- California Functional Internal Medicine Clinic LLC
- Primary Specialty
- Internal Medicine
- Enumeration Date
- Mar 4, 2024
- Last Updated
- Mar 4, 2024
Practice Location
- Address
- 22972 EL TORO RD
- City
- Lake Forest
- State
- California
- ZIP Code
- 92630-4961
- Phone
- (816) 585-4373
Authorized Official
- Name
- DR. MOHAMMED W ANSARI, MD
- Title
- MANAGING MEMBER
- Phone
- (816) 585-4373
Specialties & Taxonomy Codes
| Specialty |
|---|
| Internal Medicine |
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