# RESTORE MEDICAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619327640
- **Authorized official:** ERIC LEON (COO)
- **Authorized official phone:** (954) 641-5366

## Contact information

- **Practice address:** 16530 VENTURA BLVD, SUITE 200, ENCINO, CA 91436-4554
- **Practice address phone:** (954) 641-5366
- **Mailing address:** 16530 VENTURA BLVD, SUITE 200, ENCINO, CA 91436-4554
- **Mailing address phone:** (954) 641-5366

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | — | NULL | Yes |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/21/2016
- **Last updated:** 06/21/2016