Provider Demographics
NPI:1942734967
Name:RESTORATION HEALTH CENTER
Entity Type:Organization
Organization Name:RESTORATION HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:REZA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAKERI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:559-977-8910
Mailing Address - Street 1:2021 22ND ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-3802
Mailing Address - Country:US
Mailing Address - Phone:661-447-4200
Mailing Address - Fax:661-447-4100
Practice Address - Street 1:7011 N HOWARD ST
Practice Address - Street 2:SUITE 101
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2955
Practice Address - Country:US
Practice Address - Phone:559-261-2700
Practice Address - Fax:559-261-0333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-17
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC0259290111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty