Healthcare Provider Details

I. General information

NPI: 1689539777
Provider Name (Legal Business Name): NEWPORT HEIGHTS HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

466 E 16TH ST
COSTA MESA CA
92627-3266
US

IV. Provider business mailing address

466 E 16TH ST
COSTA MESA CA
92627-3266
US

V. Phone/Fax

Practice location:
  • Phone: 949-343-0464
  • Fax: 949-606-7497
Mailing address:
  • Phone: 949-343-0464
  • Fax: 949-606-7497

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. ADAM CORTLAND GREEN
Title or Position: OWNER
Credential:
Phone: 949-397-0658