Organization
CALIFORNIA FUNCTIONAL INTERNAL MEDICINE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHAMMED W ANSARI MD (OWNER)
(816) 585-4373
Entity
Organization
Contact information
Practice address
22972 EL TORO RD, LAKE FOREST, CA 92630-4961
(949) 339-5272
Mailing address
40 WINTERHAVEN, IRVINE, CA 92614-7914
(816) 585-4373
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
03/20/2024
Last updated
03/20/2024
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