Healthcare Provider Details

I. General information

NPI: 1881983716
Provider Name (Legal Business Name): NEWPORT CENTER EYE SPECIALISTS A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2011
Last Update Date: 08/01/2025
Certification Date: 08/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 NEWPORT CENTER DR STE 404
NEWPORT BEACH CA
92660-7687
US

IV. Provider business mailing address

400 NEWPORT CENTER DR STE 404
NEWPORT BEACH CA
92660-7687
US

V. Phone/Fax

Practice location:
  • Phone: 949-640-2023
  • Fax: 949-640-7182
Mailing address:
  • Phone: 949-640-2023
  • Fax: 949-640-7182

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LISA DORIANNE GARBUTT
Title or Position: PRESIDENT
Credential: MD
Phone: 949-640-2023