Organization
NEWPORT CENTRE OUTPATIENT SURGERY FACILITIES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL V. ELAM M.D. (OWNER)
(949) 721-1113
Entity
Organization
Contact information
Practice address
360 SAN MIGUEL DR STE 207, NEWPORT BEACH, CA 92660-7820
(949) 721-1113
Mailing address
360 SAN MIGUEL DR STE 207, NEWPORT BEACH, CA 92660-7820
(949) 721-1113
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
C38533
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C38533
STATE LICENSE NO.
CA
Enumeration date
06/12/2007
Last updated
08/22/2020
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