Healthcare Provider Details

I. General information

NPI: 1528127164
Provider Name (Legal Business Name): BETH A ARY MD INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 02/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 AVOCADO AVE #203
NEWPORT BEACH CA
92660
US

IV. Provider business mailing address

1441 AVOCADO AVE #203
NEWPORT BEACH CA
92660
US

V. Phone/Fax

Practice location:
  • Phone: 949-640-7200
  • Fax: 949-720-0203
Mailing address:
  • Phone: 949-640-7200
  • Fax: 949-720-0203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberG40599
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberG40599
License Number StateCA

VIII. Authorized Official

Name: BETH A ARY
Title or Position: OWNER
Credential: MD
Phone: 949-640-7200