Provider Demographics
NPI:1598317711
Name:NEWPORT BEACH NEUROSURGICAL INSTITUTE
Entity Type:Organization
Organization Name:NEWPORT BEACH NEUROSURGICAL INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:YANNI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-515-0053
Mailing Address - Street 1:1024 BAYSIDE DR # 230
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-7462
Mailing Address - Country:US
Mailing Address - Phone:949-515-0053
Mailing Address - Fax:
Practice Address - Street 1:1501 SUPERIOR AVE STE 214B
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3600
Practice Address - Country:US
Practice Address - Phone:949-515-0053
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-09
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty