Healthcare Provider Details

I. General information

NPI: 1942799523
Provider Name (Legal Business Name): HOAG CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2018
Last Update Date: 11/14/2022
Certification Date: 11/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 SUPERIOR AVE STE 290
NEWPORT BEACH CA
92663-3664
US

IV. Provider business mailing address

510 SUPERIOR AVE STE 290
NEWPORT BEACH CA
92663-3664
US

V. Phone/Fax

Practice location:
  • Phone: 949-764-5700
  • Fax: 949-764-5820
Mailing address:
  • Phone: 949-764-5700
  • Fax: 949-764-5820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANDREW GUARNI
Title or Position: SENIOR VICE PRESIDENT AND CFO
Credential:
Phone: 949-764-8444