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Organization
NEWPORT FAMILY MEDICINE INC A MEDICAL GROUP
Active
Organization
NEWPORT FAMILY MEDICINE INC A MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN LIAO M.D. (PRESIDENT)
(949) 644-1025
Entity
Organization
Contact information
Practice address
520 SUPERIOR AVE STE 360, NEWPORT BEACH, CA 92663-3668
(949) 644-1025
(949) 644-7852
Mailing address
520 SUPERIOR AVE STE 360, NEWPORT BEACH, CA 92663-3668
(949) 644-1025
(949) 644-7852
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
BT30019029
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DS5586
MEDICARE RAILROAD
CA
Enumeration date
05/20/2006
Last updated
12/07/2020
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