# RESTORE HEALTH CORP

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** MTM Pharmacy I
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215672613
- **Authorized official:** TINA TUYET QUACH-TRAN (OWNER/PRESIDENT/CEO)
- **Authorized official phone:** (714) 705-6992

## Contact information

- **Practice address:** 12666 BROOKHURST ST STE 110, GARDEN GROVE, CA 92840-4866
- **Practice address phone:** (714) 705-6992
- **Mailing address:** 12666 BROOKHURST ST STE 110, GARDEN GROVE, CA 92840-4866
- **Mailing address phone:** (714) 705-6992

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 04/29/2022
- **Last updated:** 05/02/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7217942 | — | CA |
| 01 | — | PHY57946 | PHARMACY LICENSE | CA |