Organization
RESTORE HEALTH CORP
Active
Organization
RESTORE HEALTH CORP
Active
Other names
MTM PHARMACY I
Organization subpart
No
Provider details
NPI number
Authorized official
TINA TUYET QUACH-TRAN PHARM D (PRESIDENT/CEO)
(714) 705-6992
Entity
Organization
Contact information
Practice address
12666 BROOKHURST ST, #110, GARDEN GROVE, CA 92840-4866
(714) 705-6992
(714) 705-6988
Mailing address
12666 BROOKHURST ST, #110, GARDEN GROVE, CA 92840-4866
(714) 705-6992
(714) 705-6988
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
CA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7217942
—
CA
01
—
PHY57946
BOARD OF PHARMACY
CA
Enumeration date
12/30/2013
Last updated
04/08/2022
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