Organization
PRIMA RESTORATIVE AND WELLNESS
Active
Organization
PRIMA RESTORATIVE AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY RYAN MIGUEL AGUIRRE MD (CEO)
(310) 993-9691
Entity
Organization
Contact information
Practice address
309 W BROADWAY, GLENDALE, CA 91204-1301
(310) 993-9691
Mailing address
309 W BROADWAY, GLENDALE, CA 91204-1301
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
11/18/2025
Last updated
11/18/2025
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