Individual
EDWARD NEYMARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4501 BIRCH ST, NEWPORT BEACH, CA 92660-1990
(949) 629-2950
(949) 606-8995
Mailing address
PO BOX 12139, NEWPORT BEACH, CA 92658-5053
(949) 629-2950
(949) 606-8995
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
A60093
CA
2085N0700X
Neuroradiology Physician
A60093
CA
2085N0904X
Nuclear Radiology Physician
A60093
CA
2085P0229X
Pediatric Radiology Physician
A60093
CA
2085R0202X
Diagnostic Radiology Physician
A60093
CA
2085R0203X
Therapeutic Radiology Physician
A60093
CA
2085R0204X
Vascular & Interventional Radiology Physician
Primary
A60093
CA
2085U0001X
Diagnostic Ultrasound Physician
A60093
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A600930
—
SC
01
—
A60093
CA MEDICAL BOARD LIC
CA
01
—
G90022
MEDICARE PTAN
CA
01
—
WG60093A
PPIN
CA
Enumeration date
08/25/2006
Last updated
03/07/2023
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