Healthcare Provider Details

I. General information

NPI: 1831029479
Provider Name (Legal Business Name): NEWPORT 56 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26062 MERIT CIR STE 108
LAGUNA HILLS CA
92653-7013
US

IV. Provider business mailing address

26062 MERIT CIR STE 108
LAGUNA HILLS CA
92653-7013
US

V. Phone/Fax

Practice location:
  • Phone: 949-446-4949
  • Fax:
Mailing address:
  • Phone: 949-446-4949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: FEDERICO D'ANDREA
Title or Position: OWNER
Credential:
Phone: 949-690-4209