Healthcare Provider Details

I. General information

NPI: 1518951300
Provider Name (Legal Business Name): HOAG MEMORIAL HOSPITAL PRESBYTERIAN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2005
Last Update Date: 06/17/2021
Certification Date: 06/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ONE HOAG DRIVE
NEWPORT BEACH CA
92663
US

IV. Provider business mailing address

1 HOAG DR
NEWPORT BEACH CA
92663-4162
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number060000122
License Number StateCA

VIII. Authorized Official

Name: ROBERT BRAITHWAITE
Title or Position: PRESIDENT/CEO
Credential:
Phone: 949-764-4410