Healthcare Provider Details

I. General information

NPI: 1033031125
Provider Name (Legal Business Name): DANIEL KOERBER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HOAG DR
NEWPORT BEACH CA
92663-4162
US

IV. Provider business mailing address

4201 JAMBOREE RD UNIT 512
NEWPORT BEACH CA
92660-3065
US

V. Phone/Fax

Practice location:
  • Phone: 949-764-4624
  • Fax:
Mailing address:
  • Phone: 949-820-0925
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberA210906
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: