MEDICARE: NEWPORT SURGERY CENTER PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician
2	208100000X	Physical Medicine & Rehabilitation Physician

General Provider Information

NPI Number	:	1033046909
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEWPORT SURGERY CENTER PC

Provider Business Mailing Address
First Line	:	1640 NEWPORT BLVD STE 230
Second Line	:
City	:	COSTA MESA
State	:	CA
Zip	:	92627-7730
Country	:	US
Telephone Number	:	949-736-5995
Fax Number	:	949-736-5997

Provider Business Practice Location Address
First Line	:	1640 NEWPORT BLVD STE 230
Second Line	:
City	:	COSTA MESA
State	:	CA
Zip	:	92627-7730
Country	:	US
Telephone Number	:	949-736-5995
Fax Number	:	949-736-5997

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DAVID NGUYEN
Credential	:	MD
Telephone Number	:	949-736-5995

Provider Enumeration Date	:	05/06/2026
Last Update Date	:	05/06/2026

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