Organization
NEWPORT PERSONAL MEDICINE, INC.
Active
Organization
NEWPORT PERSONAL MEDICINE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT STEPHEN JENNINGS M.D. (PRESIDENT)
(949) 500-5662
Entity
Organization
Contact information
Practice address
22 ODYSSEY STE 110, IRVINE, CA 92618-3186
(949) 500-5662
(949) 706-9440
Mailing address
P.O. BOX 11807, NEWPORT BEACH, CA 92658
(949) 500-5662
(949) 706-9440
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
—
—
207QA0505X
Adult Medicine Physician
—
—
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
207QS0010X
Sports Medicine (Family Medicine) Physician
—
—
Other
Enumeration date
10/20/2017
Last updated
01/04/2018
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