# RECONSTRUCTIVE SURGERY CENTER OF NEWPORT BEACH INC

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

## Provider details

- **NPI number:** 1437592169
- **Authorized official:** SIMON J MADORSKY M.D (MEDICAL DIRECTOR)
- **Authorized official phone:** (949) 200-1600

## Contact information

- **Practice address:** 180 NEWPORT CENTER DR, SUITE 150, NEWPORT BEACH, CA 92660-6972
- **Practice address phone:** (949) 200-1600
- **Practice address fax:** (949) 200-1610
- **Mailing address:** 180 NEWPORT CENTER DR, SUITE 150, NEWPORT BEACH, CA 92660-6972
- **Mailing address phone:** (949) 200-1600
- **Mailing address fax:** (949) 200-1610

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 3506862 | CA | Yes |

## Other

- **Enumeration date:** 04/11/2013
- **Last updated:** 05/11/2017