Provider Demographics
NPI:1568792083
Name:NEWPORT HEALTH NETWORK, INC
Entity Type:Organization
Organization Name:NEWPORT HEALTH NETWORK, INC
Other - Org Name:NEWPORT AUDIOLOGY CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HR
Authorized Official - Prefix:
Authorized Official - First Name:JODI
Authorized Official - Middle Name:
Authorized Official - Last Name:MABB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-385-3761
Mailing Address - Street 1:FILE 50255
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90074-0255
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:24012 CALLE DE LA PLATA
Practice Address - Street 2:SUITE 215
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-3621
Practice Address - Country:US
Practice Address - Phone:800-675-5485
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-06
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU2074237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty