05D1021035 CLIA NUMBER - NEWPORT MESA MEDICAL GROUP INC

Laboratory Demographics

CLIA Number: 05D1021035

Facility Name: NEWPORT MESA MEDICAL GROUP INC

Facility Address:
275 VICTORIA STREET SUITE 1E
COSTA MESA, CA
ZIP 92627
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Facility Phone Number: 949 574-3615

Facility Type: Other

Certificate Type: Waiver

NPI Number: 1104836956

Taxonomy: 207R00000X - Internal Medicine
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

CLIA Record

Field Name	Field Value
CLIA Number	05D1021035
LAB Type	Other
Facility Name	NEWPORT MESA MEDICAL GROUP INC
Street	275 VICTORIA STREET SUITE 1E
City	COSTA MESA
State	CA
ZIP	92627
Phone	949 574-3615
CertificateType	4
CertificateEffectiveDate	1/9/2024
CertificateExpirationDate	1/8/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024