Healthcare Provider Details

I. General information

NPI: 1720520141
Provider Name (Legal Business Name): WOMEN'S CENTER FOR UROGYNECOLOGY & ROBOTIC SURGERY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2016
Last Update Date: 10/26/2020
Certification Date: 10/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 SUPERIOR AVE STE 200
NEWPORT BEACH CA
92663-3642
US

IV. Provider business mailing address

520 SUPERIOR AVE STE 200
NEWPORT BEACH CA
92663-3642
US

V. Phone/Fax

Practice location:
  • Phone: 949-706-2500
  • Fax:
Mailing address:
  • Phone: 949-706-2500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2088F0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Urology) Physician
License Number
License Number State

VIII. Authorized Official

Name: EMAD HASHEMI
Title or Position: PRESIDENT / OWNER
Credential: MD
Phone: 949-706-2500