Provider Demographics
NPI:1942563598
Name:NEWPORT SURGERY CENTER
Entity Type:Organization
Organization Name:NEWPORT SURGERY CENTER
Other - Org Name:ORANGE COUNTY SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:
Authorized Official - Last Name:DEBARGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-221-0128
Mailing Address - Street 1:4501 BIRCH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-1990
Mailing Address - Country:US
Mailing Address - Phone:949-861-3159
Mailing Address - Fax:949-861-6325
Practice Address - Street 1:4501 BIRCH ST
Practice Address - Street 2:SUITE A
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-1990
Practice Address - Country:US
Practice Address - Phone:949-861-3159
Practice Address - Fax:949-861-6325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-19
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical