# DISC SPORTS AND SPINE CENTER AT NEWPORT BEACH

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154600070
- **Authorized official:** LAURIE DALE (CFO)
- **Authorized official phone:** (310) 574-0450

## Contact information

- **Practice address:** 3501 JAMBOREE RD, SUIUTE 1200, NEWPORT BEACH, CA 92660-2939
- **Practice address phone:** (949) 988-7888
- **Practice address fax:** (949) 509-7907
- **Mailing address:** 13160 MINDANAO WAY, SUITE 170, MARINA DEL REY, CA 90292-6358
- **Mailing address phone:** (310) 574-0450
- **Mailing address fax:** (310) 574-0371

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/09/2011
- **Last updated:** 08/09/2011