# NEWPORT INSTITUTE OF THE MINIMALLY INVASIVE SURGERY

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

## Provider details

- **NPI number:** 1639535412
- **Authorized official:** GUSTAVO GUTIERREZ CRNA (ANESTHESIOLOGIST/OWNER)
- **Authorized official phone:** (310) 386-6718

## Contact information

- **Practice address:** 455 OLD NEWPORT BLVD, STE 100, NEWPORT BEACH, CA 92663-4241
- **Practice address phone:** (714) 396-8777
- **Practice address fax:** (714) 917-4615
- **Mailing address:** 455 OLD NEWPORT BLVD, STE 100, NEWPORT BEACH, CA 92663-4241

## Taxonomy

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

## Other

- **Enumeration date:** 01/08/2016
- **Last updated:** 01/08/2016