Provider Demographics
NPI:1902675945
Name:RESTORE WEIGHT LOSS, PC
Entity Type:Organization
Organization Name:RESTORE WEIGHT LOSS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:K
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:424-488-3454
Mailing Address - Street 1:2585 PACIFIC COAST HWY
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-7035
Mailing Address - Country:US
Mailing Address - Phone:424-488-3454
Mailing Address - Fax:310-800-2833
Practice Address - Street 1:2585 PACIFIC COAST HWY
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-7035
Practice Address - Country:US
Practice Address - Phone:424-488-3454
Practice Address - Fax:310-800-2833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-01
Last Update Date:2024-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RB0002XAllopathic & Osteopathic PhysiciansInternal MedicineObesity MedicineGroup - Single Specialty