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RMG GARDEN GROVE
NPI 1881104222
Family Medicine - Geriatric Medicine in Garden Grove, CA

Active since October 11, 2017CLIA 05D2211564 · Waiver
12620 BROOKHURST ST STE 2, GARDEN GROVE, CA 92840(657) 251-0453(657) 251-0783 Get Directions Write a Review

NPPES record last updated: August 28, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 28, 2018, Oct 11, 2017 (2 updates tracked since 2017).

About Rmg Garden Grove NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RMG GARDEN GROVE (NPI 1881104222) is a healthcare organization registered as a geriatric medicine in Garden Grove, California and active in the NPI registry since October 2017. The organization holds a CLIA Waiver certificate valid through January 27, 2027 and lists Bryn Jarald Henderson, Owner, as its authorized official.

NPPES Registry Identity

NPI1881104222
Entity TypeOrganization
Primary Taxonomy207QG0300X
Legal Business NameREGENERATIVE MEDICAL GROUP
Location Address12620 BROOKHURST ST STE 2Garden Grove, CA 92840
Mailing Address615 E Chapman AveOrange, CA 92866-1643 · (714) 639-4012 · Fax (714) 639-4018
Phone(657) 251-0453
Fax(657) 251-0783
Organization SubpartNo
Authorized OfficialBryn Jarald HendersonOwner · (714) 639-4012
Enumeration DateOctober 11, 2017
Last NPPES UpdateAugust 28, 20182 updates tracked since enumeration
✔ NPI 1881104222 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Geriatric MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QG0300X
Definition
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.
12620 BROOKHURST ST STE 2, Garden Grove, CA 92840
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Other Names 1

Other NameRmg Garden Grove

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2211564

Regenerative Medical Group · Garden Grove, CA
Active · expires Jan 27, 2027
CLIA Number05D2211564
Laboratory TypePhysician Office
Certificate Effective DateJanuary 28, 2025
Certificate Expiration DateJanuary 27, 2027
Laboratory DirectorRichard Rutledge
Laboratory Phone(714) 551-9576
Laboratory LocationRegenerative Medical Group12620 Brookhurst St Ste 2, Garden Grove, CA 92840
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LEVO MEDICAL
Durable Medical Equipment & Medical Supplies
12620 BROOKHURST ST STE 2
GARDEN GROVE, CA 92840
Orange County (714) 793-3075
DR. RICHARD MICHAEL RUTLEDGE D.O.
Family Medicine
12620 BROOKHURST ST STE 2
GARDEN GROVE, CA 92840
Orange County (657) 251-0453
TELEHEALTH MEDICAL GROUP INC
Family Medicine (Geriatric Medicine)
12620 BROOKHURST ST STE 2
GARDEN GROVE, CA 92840
Orange County (657) 251-0453
STANTON S KREMSKY MD INC
Clinic/Center (Magnetic Resonance Imaging (MRI))
12620 BROOKHURST ST STE 2
GARDEN GROVE, CA 92840
Orange County (714) 530-8821

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Regenerative Medical Group's NPI number?

The NPI number for Regenerative Medical Group is 1881104222. It was assigned to this organization in the NPPES registry on October 11, 2017. The provider is also known as Rmg Garden Grove.

Where is Regenerative Medical Group located?

Regenerative Medical Group is located at 12620 Brookhurst St Ste 2, Garden Grove, CA 92840. The listed phone number is (657) 251-0453.

What is Regenerative Medical Group's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Geriatric Medicine, with taxonomy code 207QG0300X.

Does Regenerative Medical Group hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2211564) is associated with this NPI, valid through January 27, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Regenerative Medical Group was last updated on August 28, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.