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General NPI Number Information
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NPI Number | 1922061779
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Entity Type | Organization
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Legal Business Name | NEWPORT EMERGENCY MEDICAL GROUP INC
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Dates
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Enumeration Date | 04/11/2006
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Last Update Date | 01/26/2024
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Provider Practice Location Address
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Address Line | 1 HOAG DR ECU DEPT.
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City | NEWPORT BEACH
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State | CA
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Zip | 92663-4162
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Country | US
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Telephone | 949-764-5689
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Fax | 405-749-4561
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Provider Business Mailing Address
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Address Line | PO BOX 720300
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City | OKLAHOMA CITY
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State | OK
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Zip | 73172-0300
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Country | US
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Telephone | 405-751-4664
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Fax | 405-749-4561
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RAYMOND LOUIS RICCI
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Credential | MD
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Telephone | 405-751-4664
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State | CA
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