Healthcare Provider Details

I. General information

NPI: 1326205097
Provider Name (Legal Business Name): HOAG HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2008
Last Update Date: 05/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 LESSAY
NEWPORT COAST CA
92657-1017
US

IV. Provider business mailing address

1 HOAG DR CARDIOLOGY
NEWPORT BEACH CA
92663-4162
US

V. Phone/Fax

Practice location:
  • Phone: 949-764-6553
  • Fax:
Mailing address:
  • Phone: 949-764-6553
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number434593
License Number StateCA

VIII. Authorized Official

Name: DR. RICHARD AFABLE
Title or Position: CEO
Credential: M.D
Phone: 949-645-8600