Provider Demographics
NPI:1003146291
Name:ANDREW S. IRANIHA INC
Entity Type:Organization
Organization Name:ANDREW S. IRANIHA INC
Other - Org Name:NEWPORT LAPAROSCOPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LEIGH
Authorized Official - Middle Name:C
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-646-8444
Mailing Address - Street 1:496 OLD NEWPORT BLVD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-4263
Mailing Address - Country:US
Mailing Address - Phone:949-646-8444
Mailing Address - Fax:949-646-8388
Practice Address - Street 1:496 OLD NEWPORT BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-4263
Practice Address - Country:US
Practice Address - Phone:949-646-8444
Practice Address - Fax:949-646-8388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-11
Last Update Date:2010-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA055391282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA055391OtherLICENSE
CAH19151Medicare UPIN