Provider Demographics
NPI:1457324857
Name:NEWPORT COAST SURGERY CENTER, LP
Entity Type:Organization
Organization Name:NEWPORT COAST SURGERY CENTER, LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MS
Authorized Official - First Name:DELGASH
Authorized Official - Middle Name:
Authorized Official - Last Name:DOSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-644-5800
Mailing Address - Street 1:1401 AVOCADO AVE STE 709
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-8714
Mailing Address - Country:US
Mailing Address - Phone:949-644-5800
Mailing Address - Fax:949-999-8365
Practice Address - Street 1:1441 AVOCADO AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-7721
Practice Address - Country:US
Practice Address - Phone:949-718-3600
Practice Address - Fax:949-718-4320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-08
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA060000533261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAS051475AMedicare ID - Type Unspecified