Organization
NEWPORT BEACH SURGERY CENTER, LLC
Active
Other names
Newport Beach Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
LEROY TREY SAMPSON III (ADMINISTRATOR)
(949) 631-0988
Entity
Organization
Contact information
Practice address
361 HOSPITAL ROAD, SUITE 124, NEWPORT BEACH, CA 92663
(949) 631-0988
(949) 631-2504
Mailing address
361 HOSPITAL ROAD, SUITE 124, NEWPORT BEACH, CA 92663
(949) 631-0988
(949) 631-2504
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
060000339
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060000339
STATE LICENSE
CA
Enumeration date
06/02/2005
Last updated
05/05/2023
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