Provider Demographics
NPI:1114089513
Name:NEWPORT URGENT CARE INCORPORATED
Entity Type:Organization
Organization Name:NEWPORT URGENT CARE INCORPORATED
Other - Org Name:MD MEDICAL CLINICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:ALBERT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-752-6300
Mailing Address - Street 1:1000 BRISTOL ST N STE 1B
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2908
Mailing Address - Country:US
Mailing Address - Phone:949-752-6300
Mailing Address - Fax:949-752-6333
Practice Address - Street 1:1000 BRISTOL ST N
Practice Address - Street 2:STE 1B
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-8916
Practice Address - Country:US
Practice Address - Phone:949-752-6300
Practice Address - Fax:949-752-6333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG34265261QU0200X
261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW16952Medicare ID - Type Unspecified
CAA45853Medicare UPIN