Organization
CCRM NEWPORT BEACH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATT TYSON (DIRECTOR, MANAGED CARE CONTRACTING)
(615) 477-6677
Entity
Organization
Contact information
Practice address
3501 JAMBOREE RD STE 450, NEWPORT BEACH, CA 92660-2916
(949) 531-6331
Mailing address
3501 JAMBOREE RD STE 1100, NEWPORT BEACH, CA 92660-2956
(949) 222-1290
Taxonomy
Speciality
Code
Description
License number
State
207VE0102X
Reproductive Endocrinology Physician
Primary
—
—
Other
Enumeration date
02/08/2023
Last updated
07/15/2026
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