Provider Demographics
NPI:1548682545
Name:RESHEALTH MEDICAL GROUP, APC
Entity type:Organization
Organization Name:RESHEALTH MEDICAL GROUP, APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ZAIN
Authorized Official - Middle Name:
Authorized Official - Last Name:VALLY-MAHOMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-817-6364
Mailing Address - Street 1:703 PIER AVE
Mailing Address - Street 2:STE B812
Mailing Address - City:HERMOSA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90254-3949
Mailing Address - Country:US
Mailing Address - Phone:310-817-6364
Mailing Address - Fax:310-848-1347
Practice Address - Street 1:2920 INLAND EMPIRE BLVD
Practice Address - Street 2:SUITE 108
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91764-5564
Practice Address - Country:US
Practice Address - Phone:310-817-6364
Practice Address - Fax:310-848-1347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-09
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No204R00000XAllopathic & Osteopathic PhysiciansElectrodiagnostic MedicineGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty