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REGENERATIVE MEDICAL GROUP NPI 1881104222


NPI Information

NPI: 1881104222
Provider Name: REGENERATIVE MEDICAL GROUP

Other Name: RMG GARDEN GROVE

Classification: Family Medicine - 207QG0300X
Entity Type: Organization

Specialization: Geriatric Medicine

CLIA Number: 05D2211564

Address:
12620 BROOKHURST ST STE 2
GARDEN GROVE, CA
ZIP 92840
Phone: (657) 251-0453
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REGENERATIVE MEDICAL GROUP is a geriatric medicine family medicine in Garden Grove, CA. The provider is a family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. REGENERATIVE MEDICAL GROUP NPI is 1881104222. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Rmg Garden Grove.

The provider's business location address is:

12620 BROOKHURST ST STE 2
GARDEN GROVE, CA
ZIP 92840
Phone: (657) 251-0453
Fax: (657) 251-0783

The provider's authorized official is Bryn Jarald Henderson .
The authorized official title is Owner and has the following contact phone number (714) 639-4012.

The CLIA number assigned to this NPI record is 05D2211564 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/11/2017 and was last updated on 8/28/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207QG0300XFamily MedicineGeriatric MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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