Organization
NEWPORT COAST PATHOLOGY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANI EHTESHAMI M.D., M.S. (MEDICAL DIRECTOR AND PRESIDENT)
(888) 463-3606
Entity
Organization
Contact information
Practice address
27 CLERMONT, NEWPORT BEACH, CA 92657-1069
(949) 706-2796
(949) 706-2072
Mailing address
27 CLERMONT, NEWPORT BEACH, CA 92657-1069
(949) 706-2796
(949) 706-2072
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
G74263
CA
Other
Enumeration date
04/30/2010
Last updated
11/01/2011
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