Elite Surgical

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

ELITE SURGICAL

Practice address

496 Old Newport Blvd Ste 6
Newport Beach, CA 92663-4264

Phone

(949) 722-7662

Fax

(949) 631-6585

NPI assigned

Mar 16, 2018

Organization subpart

No

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

Authorized official

Name

Tammy Poliquin

Title

Office MGR

Phone

(949) 722-7662

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1521158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521158400000",
    "number": "1669975595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "496 OLD NEWPORT BLVD STE 6",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926634264",
            "telephone_number": "949-722-7662",
            "fax_number": "949-631-6585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "496 OLD NEWPORT BLVD STE 6",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926634264",
            "telephone_number": "949-722-7662",
            "fax_number": "949-631-6585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE SURGICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-16",
        "last_updated": "2018-03-16",
        "status": "A",
        "authorized_official_last_name": "POLIQUIN",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "OFFICE MGR",
        "authorized_official_telephone_number": "949-722-7662"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elda Aghaian MD Inc
• Cody Dalton Elder, LMFT, APCC
• Eleanor Kelly, MD, Inc
• Elite Care, Inc.
• Elite Physicians Group PC
• Eliza-Jasmine Tran, MD Inc.
• Elizabeth Pusey MD Inc
• Julia A Elizondo, PT, OCS
• Laila M. Elkeeb, MD
• Jordan Dulay Ellfeldt, OD

• Surgery Physician in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2018; 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.