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General NPI Number Information
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NPI Number | 1336229822
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Entity Type | Organization
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Legal Business Name | GASTROENTEROLOGY ALLIANCE OF NEWPORT, A MEDICAL PARTNERSHIP
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 361 HOSPITAL RD STE 331
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City | NEWPORT BEACH
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State | CA
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Zip | 92663-3522
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Country | US
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Telephone | 949-650-8700
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Fax | 949-650-0877
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Provider Business Mailing Address
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Address Line | 361 HOSPITAL RD STE 331
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City | NEWPORT BEACH
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State | CA
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Zip | 92663-3522
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Country | US
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Telephone | 949-650-8700
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Fax | 949-650-0877
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Authorized Official
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Title or Position | PARTNER/OWNER
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Name | RICHARD G QUIST
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Credential | M.D.
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Telephone | 949-650-8700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | G42979
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License Number State | CA
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