Provider Demographics
NPI:1598125296
Name:NEWPORT ACUPUNCTURE CENTER
Entity Type:Organization
Organization Name:NEWPORT ACUPUNCTURE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:OH
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:949-244-8862
Mailing Address - Street 1:2043 WESTCLIFF DR STE 301
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-5511
Mailing Address - Country:US
Mailing Address - Phone:949-244-8862
Mailing Address - Fax:949-627-8299
Practice Address - Street 1:2043 WESTCLIFF DR STE 301
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-5511
Practice Address - Country:US
Practice Address - Phone:949-244-8862
Practice Address - Fax:949-627-8299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-24
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL.AC9930171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty