Organization
NEWPORT SPECIALIST INC
Active
Organization
NEWPORT SPECIALIST INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SYLVIA NUTTALL (PRACTICE MANAGER)
(949) 650-0587
Entity
Organization
Contact information
Practice address
1419 SUPERIOR AVE STE 1, NEWPORT BEACH, CA 92663-2723
(949) 650-0587
(949) 650-0587
Mailing address
610 NEWPORT CENTER DR STE 230, NEWPORT BEACH, CA 92660-6451
(949) 650-0587
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
10/05/2017
Last updated
10/05/2017
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