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Organization

NEWPORT COAST RECOVERY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MICHAEL RUDOLPH M.D. (MEDICAL DIRECTOR)
(949) 673-3097
Entity
Organization

Contact information

Practice address
1500 W BALBOA BLVD, SUITE 204, NEWPORT BEACH, CA 92663-4548
(949) 673-3097
(949) 673-3098
Mailing address
1500 W BALBOA BLVD, SUITE 204, NEWPORT BEACH, CA 92663-4548
(949) 673-3097
(949) 673-3098

Taxonomy

Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
300156AP
CA

Other

Enumeration date
05/13/2009
Last updated
05/13/2009
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