Provider Demographics
NPI:1619423282
Name:NEWPORT HARBOR PATHOLOGY MEDICAL GROUP INC
Entity Type:Organization
Organization Name:NEWPORT HARBOR PATHOLOGY MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:EPSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-764-4624
Mailing Address - Street 1:2901 W COAST HWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-4023
Mailing Address - Country:US
Mailing Address - Phone:949-764-4624
Mailing Address - Fax:949-764-5435
Practice Address - Street 1:805 W LA VETA AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3901
Practice Address - Country:US
Practice Address - Phone:714-997-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory