Organization
NEWPORT HARBOR RADIOLOGY ASSOCIATES MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HUMBERTO WONG (AUTHORIZED OFFICIAL)
(949) 645-3534
Entity
Organization
Contact information
Practice address
ONE HOAG DRIVE, NEWPORT BEACH, CA 92663-4162
(949) 764-5570
Mailing address
DEPT LA 21555, PASADENA, CA 91185-1555
(949) 263-8620
(800) 409-7005
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207U00000X
Nuclear Medicine Physician
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053355792
—
CA
01
—
ZZZ78642Z
BLUE SHIELD
CA
05
—
ZZZ78642Z
—
CA
Enumeration date
06/15/2006
Last updated
01/28/2026
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