Provider Demographics
NPI:1740484633
Name:PERSONALCARE PHYSICIANS OF NEWPORT BEACH INC
Entity type:Organization
Organization Name:PERSONALCARE PHYSICIANS OF NEWPORT BEACH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:S
Authorized Official - Last Name:CHENG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-706-3300
Mailing Address - Street 1:2121 E COAST HWY STE 250
Mailing Address - Street 2:
Mailing Address - City:CORONA DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92625-1932
Mailing Address - Country:US
Mailing Address - Phone:949-706-3300
Mailing Address - Fax:949-706-3301
Practice Address - Street 1:2121 E COAST HWY STE 250
Practice Address - Street 2:
Practice Address - City:CORONA DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92625-1932
Practice Address - Country:US
Practice Address - Phone:949-706-3300
Practice Address - Fax:949-706-3301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty