Elite Surgical
Surgery in Newport Beach, CA. Organization (NPI-2).
NPI number1669975595
StatusActive
Last updated in NPPESMar 16, 2018
Details
- NPI
- 1669975595
- Entity type
- Organization (NPI-2)
- Legal business name
- Elite Surgical
- Organization subpart
- No
- Enumeration date
- Mar 16, 2018
- Last updated
- Mar 16, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208600000X | Surgery | – | – | Yes |
Practice location
496 Old Newport Blvd Ste 6Newport Beach, CA 92663-4264
Phone 949-722-7662 · Fax 949-631-6585
Mailing address
496 Old Newport Blvd Ste 6Newport Beach, CA 92663-4264
Phone 949-722-7662 · Fax 949-631-6585
Authorized official
Tammy Poliquin
Office Mgr
9497227662
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