# MARY J. KOTOB, MD, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Dr Mary J Kotob
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083400220
- **Authorized official:** DR. MARY J KOTOB MD (OWNER)
- **Authorized official phone:** (714) 357-3202

## Contact information

- **Practice address:** 400 NEWPORT CENTER DR STE 202, NEWPORT BEACH, CA 92660-7639
- **Practice address phone:** (949) 520-7774
- **Practice address fax:** (949) 520-7731
- **Mailing address:** 400 NEWPORT CENTER DR STE 202, NEWPORT BEACH, CA 92660-7639
- **Mailing address phone:** (949) 520-7774
- **Mailing address fax:** (949) 520-7731

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 04/15/2025
- **Last updated:** 04/15/2025