Organization
FL & CO
Active
Other names
NEWPORT COAST PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN LYN PHARMD (VICE PRESIDENT)
(949) 719-3707
Entity
Organization
Contact information
Practice address
400 NEWPORT CENTER DR, SUITE 106, NEWPORT BEACH, CA 92660-7601
(949) 719-3707
(949) 719-3713
Mailing address
PO BOX 54468, IRVINE, CA 92619-4468
(949) 719-3707
(949) 719-3713
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
5998960001
CA
333600000X
Pharmacy
PHY48317
CA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0501115
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
PHA483170
—
CA
Enumeration date
10/23/2006
Last updated
06/20/2008
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