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Organization
PORCUPINE CROSSING LLC
Active
Organization
PORCUPINE CROSSING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN NEWBERRY (AUTHORIZED OFFICIAL)
(385) 454-5027
Entity
Organization
Contact information
Practice address
12681 HASTER ST, GARDEN GROVE, CA 92840-6040
(385) 454-5027
Mailing address
3401 N THANKSGIVING WAY STE 190, LEHI, UT 84048-4157
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
04/09/2026
Last updated
04/09/2026
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