Organization
NEWPORT BEACH SURGICAL AND MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SIMON J. MADORSKY M.D. (PRESIDENT)
(949) 719-1800
Entity
Organization
Contact information
Practice address
180 NEWPORT CENTER DR, SUITE 158, NEWPORT BEACH, CA 92660-6972
(949) 719-1800
(949) 719-1810
Mailing address
PO BOX 6765, ORANGE, CA 92863-6765
(714) 571-5000
(714) 571-5055
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
—
—
207Y00000X
Otolaryngology Physician
Primary
—
—
207YS0123X
Facial Plastic Surgery Physician
—
—
Other
Enumeration date
08/26/2014
Last updated
12/04/2014
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