SCOTT K. FORMAN M.D. PROFESSIONAL CORPORATION (NPI# 1528301710) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528301710 |
| Entity Type | Organization |
| Organization Name | SCOTT K. FORMAN M.D. PROFESSIONAL CORPORATION |
| Practice Address |
360 San Miguel Dr #701 Newport Beach CA 92660-7853 |
| Practice Telephone | 9497593600 |
| Practice Fax Number | 9497599265 |
| Mailing Telephone | 9497593600 |
| Mailing Fax Number | 9497599265 |
| Enumeration Date | 2013-04-05 |
| Last Update Date | 2013-04-24 |
| Authorized Official Name | CATHY S NEILSON (MANAGER) |
| Authorized Official Telephone | 9497593600 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | G71209 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | UPIN | F31830 | 01 |
| Street Address |
360 SAN MIGUEL DR #701 |
| City | NEWPORT BEACH |
| State | CA |
| Zip Code | 92660-7853 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821093311 | Cory Lynne Brame | Ophthalmology | 360 San Miguel Dr, Ste 307, Newport Beach, CA 92660-7829 | 2005-06-20 |
| 1740674415 | Ewelina Szymanowicz | Nurse Practitioner | 360 San Miguel Dr, Suite 309, Newport Beach, CA 92660-7853 | 2015-03-20 |
| 1215341730 | Matthew James Belmont | Physician Assistant | 360 San Miguel Dr, Suite 107, Newport Beach, CA 92660-7853 | 2014-06-12 |
| 1336575257 | Sheets, Paquette & Wu Dental Practice | Clinic/Center | 360 San Miguel Dr, Suite 204, Newport Beach, CA 92660-7853 | 2013-09-24 |
| 1932444395 | Jennifer June Rhoton | Nurse Practitioner | 360 San Miguel Dr, Suite 107, Newport Beach, CA 92660-7853 | 2012-12-11 |
| 1568717122 | Jean Chin Wu | Dentist | 360 San Miguel Dr, #204, Newport Beach, CA 92660 | 2012-07-19 |
| 1326334202 | Riviera Medical Corporation | Non-Pharmacy Dispensing Site | 360 San Miguel Dr, Suite 107, Newport Beach, CA 92660-7853 | 2011-06-20 |
| 1700188174 | Edward G. Rohaly,m.d. Inc. | Clinic/Center | 360 San Miguel Dr, Suite 309, Newport Beach, CA 92660-7829 | 2010-11-17 |
| 1093024739 | Chalinee Jill Intarachote | Physical Medicine & Rehabilitation | 360 San Miguel Dr, 301, Newport Beach, CA 92660-7853 | 2010-09-29 |
| 1417265562 | Heather Ryan | Physician Assistant | 360 San Miguel Dr, Suite 701, Newport Beach, CA 92660-7853 | 2010-09-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275144024 | Lumins Aesthetic and Wellness, Inc | Dermatology | 20281 Sw Birch St, Suite 201, Newport Beach, CA 92660 | 2020-08-14 |
| 1205445798 | Felecia A Pedrogo | Marriage & Family Therapist | 5020 Campus Street, Newport Beach, CA 92660 | 2020-07-30 |
| 1649898388 | Polyviou Dental Corportation, Inc. | Clinic/Center | 120 Newport Beach Drive, Suite 27, Newport Beach, CA 92660 | 2020-07-09 |
| 1154974525 | Jan M. Eckermann, Md Inc. | Neurological Surgery | 1617 W Cliff Dr, Ste 203, Newport Beach, CA 92660 | 2019-07-24 |
| 1235792219 | Horizon Dermatology and Laser Institute | Dermatology | 369 San Miguel Dr. Suite 200, Newport Beach, CA 92660 | 2019-04-16 |
| 1902366925 | Yasmine Central Gohar | Marriage & Family Therapist | 20271 Sw Birch St Ste 200, Newport Beach, CA 92660 | 2019-03-25 |
| 1245703255 | Charison Counseling | Counselor | 4000 Macarthur Bvd Suite 600 East Tower, Newport Beach, CA 92660 | 2019-01-03 |
| 1134698996 | Amber Werner | Chiropractor | 4029 Westerly Place, Suite #115, Newport Beach, CA 92660 | 2018-11-21 |
| 1861969008 | Healthy Me Oc | Dietitian, Registered | 4569 Macarthur Court, Suite 1100, Newport Beach, CA 92660 | 2018-10-25 |
| 1174015192 | Edwin Enwia | Clinic/Center | 1000 Bristol St N Ste 1b, Newport Beach, CA 92660 | 2018-06-05 |
| Find all providers in zip 92660 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265922397 | Theodore K Gregorius Md Inc | Orthopaedic Surgery | 360 San Miguel Dr., Ste. 701, Newport Beach, CA 92660 | 2018-05-15 |
| 1144523580 | Socal Spine & Orthopedic Oncology Inc. | Orthopaedic Surgery | 3700 Campus Dr Ste 104, Newport Beach, CA 92660-2603 | 2010-12-07 |
| 1942463112 | Kasra Rowshan | Orthopaedic Surgery | 3300 W Coast Hwy Ste A, Newport Beach, CA 92663-4025 | 2008-07-08 |
| 1689853996 | Thomas B. Viehe, M.d., A Professional Corporation | Orthopaedic Surgery | 1303 Avocado Ave Ste 195, Newport Beach, CA 92660-7803 | 2007-11-02 |
| 1730392192 | Edward Joseph Troy | Orthopaedic Surgery | 601 Kings Pl, Newport Beach, CA 92663-5852 | 2007-05-08 |
| 1619063799 | Hamid R. Mir | Orthopaedic Surgery | 3501 Jamboree Rd, Suite 1250, Newport Beach, CA 92660-2939 | 2006-10-05 |
| 1124035902 | Kamran Aflatoon | Orthopaedic Surgery | 3700 Campus Dr, Ste 104, Newport Beach, CA 92660-2603 | 2006-08-02 |
| 1255362406 | Lyg, A Professional Medical Corporation | Orthopaedic Surgery | 1401 Avocado Ave Ste 105, Newport Beach, CA 92660-7710 | 2006-07-05 |
| 1073586855 | Raymond E. Berg | Orthopaedic Surgery | 24 Old Course Dr, Newport Beach, CA 92660-4276 | 2006-02-10 |
| 1750363149 | David A Petersen | Orthopaedic Surgery | 361 Hospital Rd Ste 527, Newport Beach, CA 92663-3526 | 2005-11-19 |
| Find all providers in NEWPORT BEACH | ||||
| City | NEWPORT BEACH |
| Zip Code | 92660 |
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| 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.