Healthcare Provider Details

I. General information

NPI: 1134055619
Provider Name (Legal Business Name): ORTHOPEDIC INSTITUTE OF NEWPORT BEACH LIMITED PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19582 BEACH BLVD STE 306
HUNTINGTON BEACH CA
92648-5923
US

IV. Provider business mailing address

22 CORPORATE PLAZA DR
NEWPORT BEACH CA
92660-7985
US

V. Phone/Fax

Practice location:
  • Phone: 949-722-7038
  • Fax: 949-630-4900
Mailing address:
  • Phone: 949-722-7038
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: LAURIE ANN GALLAGHER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 949-722-5030