Healthcare Provider Details

I. General information

NPI: 1174709661
Provider Name (Legal Business Name): INTERNAL MEDICINE PHYSICIANS OF NEWPORT BEACH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2008
Last Update Date: 11/20/2023
Certification Date: 11/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12231 NEWPORT AVE
NORTH TUSTIN CA
92705-3205
US

IV. Provider business mailing address

PO BOX 1904
SUISUN CITY CA
94585-4904
US

V. Phone/Fax

Practice location:
  • Phone: 949-640-0635
  • Fax: 714-730-8250
Mailing address:
  • Phone: 657-241-3600
  • Fax: 657-241-7708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ERICA MICHAELA KUHN
Title or Position: PRESIDENT
Credential: D.O.
Phone: 949-640-0635