# NEWPORT CENTER MEDICAL GROUP

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

## Provider details

- **NPI number:** 1467478008
- **Authorized official:** DR. RONALD MARK TILSEN M.D. (MANAGING PARTNER)
- **Authorized official phone:** (949) 720-4920

## Contact information

- **Practice address:** 400 NEWPORT CENTER DR, SUITE 504, NEWPORT BEACH, CA 92660-7601
- **Practice address phone:** (949) 720-4920
- **Practice address fax:** (949) 720-4928
- **Mailing address:** 400 NEWPORT CENTER DR, SUITE 504, NEWPORT BEACH, CA 92660-7601
- **Mailing address phone:** (949) 720-4920
- **Mailing address fax:** (949) 720-4928

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | NULL | Yes |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/15/2006
- **Last updated:** 08/25/2015