Organization
FUNCTIONAL RESTORATION MEDICAL CENTER, INC,
Active
Other names
GARDEN GROVE IMAGING
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOOSA HEIKALI M.D. (MEDICAL DIRECTOR)
(310) 432-1000
Entity
Organization
Contact information
Practice address
12828 HARBOR BLVD, SUITE 200, GARDEN GROVE, CA 92840-5831
(714) 620-8200
(714) 620-8211
Mailing address
9134 W OLYMPIC BLVD, BEVERLY HILLS, CA 90212-3540
(310) 432-1000
(310) 432-4321
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Enumeration date
09/26/2006
Last updated
08/22/2020
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