Newport Coast Recovery

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

300156AP Issued in CA

Legal business name

NEWPORT COAST RECOVERY

Practice address

1500 W Balboa Blvd
Suite 204
Newport Beach, CA 92663-4548

Phone

(949) 673-3097

Fax

(949) 673-3098

NPI assigned

May 13, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Michael Rudolph, M.D.

Title

Medical Director

Phone

(949) 673-3097

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1242172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242172800000",
    "number": "1003040445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 W BALBOA BLVD",
            "address_2": "SUITE 204",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926634548",
            "telephone_number": "949-673-3097",
            "fax_number": "949-673-3098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 W BALBOA BLVD",
            "address_2": "SUITE 204",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926634548",
            "telephone_number": "949-673-3097",
            "fax_number": "949-673-3098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWPORT COAST RECOVERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-13",
        "last_updated": "2009-05-13",
        "status": "A",
        "authorized_official_last_name": "RUDOLPH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "949-673-3097",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "300156AP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Newport Coast Dermatology
• Newport Coast Outpatient Surgery Center
• Newport Coast Pathology, Inc.
• Newport Coast Plastic Surgery, a Medical Corporation
• Newport Coast Radiation Oncology Medical Group, Inc
• Newport Coast Surgery Center, LP
• Newport Coast Surgical and Pain Center, LLC
• Newport Coast Surgical Center, LLC
• Newport Coast Vein Care, Inc.
• Newport Cosmetic Dental Associates

• Substance Abuse Rehabilitation Facility in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Substance Abuse Rehabilitation Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.