NEWPORT PERSONAL MEDICINE, INC.


Address: 22 Odyssey Ste 110, Irvine, CA 92618-3186
Phone: 9495005662

NEWPORT PERSONAL MEDICINE, INC. (NPI# 1336650068) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1336650068
Entity Type Organization
Organization Name NEWPORT PERSONAL MEDICINE, INC.
Practice Address 22 Odyssey Ste 110
Irvine
CA 92618-3186
Mailing Address P.o. Box 11807
Newport Beach
CA 92658
Practice Telephone 9495005662
Practice Fax Number 9497069440
Mailing Telephone 9495005662
Mailing Fax Number 9497069440
Enumeration Date 2017-10-20
Last Update Date 2018-01-04
Authorized Official Name DR. ROBERT STEPHEN JENNINGS (PRESIDENT)
Authorized Official Telephone 9495005662
Authorized Official Credential M.D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207Q00000X Family Medicine Allopathic & Osteopathic Physicians
N 207QA0505X Family Medicine
Specialization: Adult Medicine
Allopathic & Osteopathic Physicians
N 207QG0300X Family Medicine
Specialization: Geriatric Medicine
Allopathic & Osteopathic Physicians
N 207QS0010X Family Medicine
Specialization: Sports Medicine
Allopathic & Osteopathic Physicians
Y 207QA0401X Family Medicine
Specialization: Addiction Medicine
Allopathic & Osteopathic Physicians

Office Location

Street Address 22 ODYSSEY STE 110
City IRVINE
State CA
Zip Code 92618-3186

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Taxonomy Information

Taxonomy Code 207QA0401X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine
Specialization Addiction Medicine

Taxonomy Definition

A family medicine physician who specializes in the diagnosis and treatment of addictions.
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Family Physicians.

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Competitor

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City IRVINE
Zip Code 92618

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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