Provider Demographics
NPI:1528026861
Name:INSTITUTE FOR RESTORATIVE HEALTH
Entity Type:Organization
Organization Name:INSTITUTE FOR RESTORATIVE HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:I
Authorized Official - Last Name:HASSID
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:530-297-7026
Mailing Address - Street 1:1460 DREW AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-4889
Mailing Address - Country:US
Mailing Address - Phone:530-297-7026
Mailing Address - Fax:
Practice Address - Street 1:1460 DREW AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-4889
Practice Address - Country:US
Practice Address - Phone:530-297-7026
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG754782084N0400X
CAA87957208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
Not Answered208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty