Provider Demographics
NPI:1083465751
Name:NEWPORT CARE MEDICAL GROUP INC
Entity Type:Organization
Organization Name:NEWPORT CARE MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KASRA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROWSHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-491-9991
Mailing Address - Street 1:441 OLD NEWPORT BLVD
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-4210
Mailing Address - Country:US
Mailing Address - Phone:949-491-9991
Mailing Address - Fax:
Practice Address - Street 1:40700 CALIFORNIA OAKS RD STE 205
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-5789
Practice Address - Country:US
Practice Address - Phone:949-491-9991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-29
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies