Provider Demographics
NPI:1295234789
Name:M HUGH BAILEY MD FACS PC INC
Entity type:Organization
Organization Name:M HUGH BAILEY MD FACS PC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:HUGH
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-650-6710
Mailing Address - Street 1:351 HOSPITAL RD STE 617
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-3508
Mailing Address - Country:US
Mailing Address - Phone:949-650-6710
Mailing Address - Fax:
Practice Address - Street 1:351 HOSPITAL RD STE 617
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3508
Practice Address - Country:US
Practice Address - Phone:949-650-6710
Practice Address - Fax:949-650-6713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-09
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA48435261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA48435OtherMEDICAL BOARD OF CALIFORNIA LICENSE NUMBER