Organization
NEWPORT CRITICAL CARE PHYSICIANS MEDICAL GROUP INC
Active
Organization
NEWPORT CRITICAL CARE PHYSICIANS MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REBECA LAGUNA (CREDENTIALING MANAGER)
(442) 600-5128
Entity
Organization
Contact information
Practice address
ONE HOAG DRIVE, 3 NORTH INTENSIVIST OFFICE, NEWPORT BEACH, CA 92663-4162
(949) 764-6875
(949) 764-6874
Mailing address
PO BOX 749226, LOS ANGELES, CA 90074-9226
(949) 263-8620
(949) 263-1639
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
—
—
207RP1001X
Pulmonary Disease Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0090550
—
CA
01
—
ZZZ02938Z
BLUE SHIELD OF CA
CA
Enumeration date
06/08/2006
Last updated
04/11/2024
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