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General NPI Number Information
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NPI Number | 1245775360
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Entity Type | Organization
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Legal Business Name | NEWPORT PHYSICAL MEDICINE AND REHABILITATION INC.
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Dates
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Enumeration Date | 12/28/2016
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Last Update Date | 01/29/2021
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Provider Practice Location Address
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Address Line | 17264 RED HILL AVE
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City | IRVINE
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State | CA
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Zip | 92614-5628
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Country | US
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Telephone | 949-650-1228
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Fax |
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Provider Business Mailing Address
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Address Line | 17264 RED HILL AVE
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City | IRVINE
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State | CA
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Zip | 92614-5628
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. VINOD MALHORTA
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Credential | MD
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Telephone | 949-650-1228
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P0004X
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Taxonomy Name | Spinal Cord Injury Medicine Physician
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License Number | A31505
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License Number State | CA
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