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General NPI Number Information
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NPI Number | 1700471422
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Entity Type | Organization
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Legal Business Name | NEWPORT MESA MEDICAL AND ACUPUNCTURE INC.
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Dates
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Enumeration Date | 03/04/2021
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Last Update Date | 03/04/2021
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Provider Practice Location Address
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Address Line | 2675 IRVINE AVE STE 100
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City | COSTA MESA
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State | CA
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Zip | 92627-6674
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Country | US
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Telephone | 949-631-6042
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Fax | 949-631-6057
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Provider Business Mailing Address
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Address Line | 2675 IRVINE AVE STE 100
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City | COSTA MESA
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State | CA
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Zip | 92627-6674
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Country | US
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Telephone | 949-631-6042
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MR. JONATHAN EARL RAGLAND
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Credential |
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Telephone | 949-631-6042
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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