Healthcare Provider Details

I. General information

NPI: 1477858546
Provider Name (Legal Business Name): NEWPORT NEUROHOSPITALISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2011
Last Update Date: 01/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 SUPERIOR AVE STE 280
NEWPORT BEACH CA
92663
US

IV. Provider business mailing address

PO BOX 15847
NEWPORT BEACH CA
92659
US

V. Phone/Fax

Practice location:
  • Phone: 949-764-8070
  • Fax: 949-650-4585
Mailing address:
  • Phone: 949-574-4652
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID BROWN
Title or Position: PRESIDENT
Credential:
Phone: 949-764-8070