Healthcare Provider Details

I. General information

NPI: 1497555379
Provider Name (Legal Business Name): 180 HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2025
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 CORPORATE PLAZA DR STE 150
NEWPORT BEACH CA
92660-7936
US

IV. Provider business mailing address

4 CORPORATE PLAZA DR STE 150
NEWPORT BEACH CA
92660-7936
US

V. Phone/Fax

Practice location:
  • Phone: 310-779-7416
  • Fax:
Mailing address:
  • Phone: 855-339-1107
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DAYLE GRAEME BURTON
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 855-339-1107