Healthcare Provider Details

I. General information

NPI: 1447336276
Provider Name (Legal Business Name): MARIA MAGDALENA BRIGHT NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 02/25/2023
Certification Date: 01/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

351 HOSPITAL RD STE 611
NEWPORT BEACH CA
92663-3508
US

IV. Provider business mailing address

23792 VIA EL ROCIO
MISSION VIEJO CA
92691-3518
US

V. Phone/Fax

Practice location:
  • Phone: 949-720-9848
  • Fax: 949-720-9195
Mailing address:
  • Phone: 949-310-0656
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberRN484886
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: