Provider Demographics
NPI:1609125525
Name:RESTPADD INC PHF
Entity Type:Organization
Organization Name:RESTPADD INC PHF
Other - Org Name:RESTPADD INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OKECHUKWU
Authorized Official - Middle Name:
Authorized Official - Last Name:NWANGBURUKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-405-6016
Mailing Address - Street 1:P O BOX 581086
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758
Mailing Address - Country:US
Mailing Address - Phone:916-405-6016
Mailing Address - Fax:
Practice Address - Street 1:2750 EUREKA WAY
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-0223
Practice Address - Country:US
Practice Address - Phone:530-262-6700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RESTPADD INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-09-06
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital