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Contact Information

RESTORE INTERVENTIONAL SPINE & SPORTS MEDICINE LLC
9925 SW NIMBUS AVE
SUITE 100
BEAVERTON, OR97008
 Phone: 503-535-8302
 Fax: 503-416-8732
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pain Medicine

2081P2900X 25 Physician/Physical Medicine and Rehabilitation
 

Vascular & Interventional Radiology

2085R0204X 94 Physician/Interventional Radiology
Indicates primary specialty

NPI Profile & details for RESTORE INTERVENTIONAL SPINE & SPORTS MEDICINE LLC

NPI Number 1801139019
LBN Legal business name RESTORE INTERVENTIONAL SPINE & SPORTS MEDICINE LLC
Authorized official RAHUL DESAI - (OWNER / CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 04/05/2013
Last updated 10/10/2016 - About 10 years ago
Identifiers
OR License # DO150752
OR License # MD28444
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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