Provider Demographics
NPI:1760861728
Name:NEWPORT MEDICAL AND ACUPUNCTURE HEALTH CENTER INC.
Entity Type:Organization
Organization Name:NEWPORT MEDICAL AND ACUPUNCTURE HEALTH CENTER INC.
Other - Org Name:NEWPORT MEDICAL AND ACUPUNCTURE
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHAN - RAGLAND
Authorized Official - Suffix:
Authorized Official - Credentials:L AC
Authorized Official - Phone:949-631-6042
Mailing Address - Street 1:2675 IRVINE AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627-4653
Mailing Address - Country:US
Mailing Address - Phone:949-631-6042
Mailing Address - Fax:949-631-6057
Practice Address - Street 1:2675 IRVINE AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627-4653
Practice Address - Country:US
Practice Address - Phone:949-631-6042
Practice Address - Fax:949-631-6057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-23
Last Update Date:2015-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26387111N00000X
CAAC6304171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty