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General NPI Number Information
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NPI Number | 1902778459
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Entity Type | Organization
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Legal Business Name | SP MEDICAL PC
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Dates
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Enumeration Date | 09/23/2025
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 4695 MACARTHUR CT STE 1100
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-1866
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Country | US
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Telephone | 949-253-5953
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Fax |
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Provider Business Mailing Address
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Address Line | 4695 MACARTHUR CT STE 1100
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-1866
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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 | MEDICAL DIRECTOR
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Name | DR. PHILIP WASEF
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Credential | MD
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Telephone | 727-723-4392
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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