Healthcare Provider Details

I. General information

NPI: 1033046909
Provider Name (Legal Business Name): NEWPORT SURGERY CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1640 NEWPORT BLVD STE 230
COSTA MESA CA
92627-7730
US

IV. Provider business mailing address

1640 NEWPORT BLVD STE 230
COSTA MESA CA
92627-7730
US

V. Phone/Fax

Practice location:
  • Phone: 949-736-5995
  • Fax: 949-736-5997
Mailing address:
  • Phone: 949-736-5995
  • Fax: 949-736-5997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID NGUYEN
Title or Position: PRESIDENT
Credential: MD
Phone: 949-736-5995