Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

California Functional Internal Medicine Clinic LLC

Organization Internal Medicine Physician · NPI 1609633049

California Functional Internal Medicine Clinic LLC is an Internal Medicine Physician in Lake Forest, California. Registered with an NPI since 2024.

In the registry since
2024
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

22972 El Toro Rd
Lake Forest, CA 92630-4961
Phone: (816) 585-4373
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X

Record details

NPI number1609633049
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mohammed Ansari — Managing Member · (816) 585-4373
NPI enumeratedMarch 4, 2024
Last updated in NPPESMarch 4, 2024
Certification dateMarch 2, 2024
Mailing address22972 El Toro Rd, Lake Forest, CA 92630-4961

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