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NEWPORT BEACH SURGICAL AND MEDICAL GROUP INC NPI 1477953511


NPI Information

NPI: 1477953511
Provider Name: NEWPORT BEACH SURGICAL AND MEDICAL GROUP INC
Classification: Otolaryngology - 207Y00000X
Entity Type: Organization

CLIA Number: 05D1103389

Address:
180 NEWPORT CENTER DR
SUITE 158
NEWPORT BEACH, CA
ZIP 92660
Phone: (949) 719-1800
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NEWPORT BEACH SURGICAL AND MEDICAL GROUP INC is an otolaryngology in Newport Beach, CA. The provider is an otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. NEWPORT BEACH SURGICAL AND MEDICAL GROUP INC NPI is 1477953511. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

180 NEWPORT CENTER DR
SUITE 158
NEWPORT BEACH, CA
ZIP 92660-972
Phone: (949) 719-1800
Fax: (949) 719-1810

The provider's authorized official is Simon J. Madorsky .
The authorized official title is President and has the following contact phone number (949) 719-1800.

The CLIA number assigned to this NPI record is 05D1103389 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 8/26/2014 and was last updated on 12/4/2014.


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
1207N00000XDermatologyNo
2207YS0123XOtolaryngologyFacial Plastic SurgeryNo
3207Y00000XOtolaryngologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1CB221699MEDICARE PINCALIFORNIA

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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