Newport Family Medicine Inc a Medical Group

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

BT30019029 Issued in CA

Legal business name

NEWPORT FAMILY MEDICINE INC A MEDICAL GROUP

Practice address

520 Superior Ave Ste 360
Newport Beach, CA 92663-3668

Phone

(949) 644-1025

Fax

(949) 644-7852

NPI assigned

May 20, 2006

Organization subpart

No

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

Authorized official

Name

Justin Liao, M.D.

Title

President

Phone

(949) 644-1025

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Petra Paule, M.D.

  • Family Medicine Physician
  • Newport Beach, CA
  • NPI 1922158468
  NPD (past)
• Sonali Ray, M.D

  • Family Medicine Physician
  • Newport Beach, CA
  • NPI 1578507356
  NPD (past)
• Olympia Kovich, MD

  • Dermatopathology Physician
  • Plainville, MA
  • NPI 1558312272
  NPD (past)

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607299200000",
    "number": "1760436992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 SUPERIOR AVE STE 360",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633668",
            "telephone_number": "949-644-1025",
            "fax_number": "949-644-7852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 SUPERIOR AVE STE 360",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633668",
            "telephone_number": "949-644-1025",
            "fax_number": "949-644-7852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWPORT FAMILY MEDICINE INC A MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A",
        "authorized_official_last_name": "LIAO",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-644-1025",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "BT30019029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DS5586",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Newport Diagnostic Radiology, Inc
• Newport Doctors Medical Group Inc
• Newport Emergency Medical Group Inc
• Newport Endocrine Associates
• Newport Endodontic Group
• Newport Family Medicine, Inc
• Newport Foot & Ankle Center, Inc
• Newport Functional Management Inc.
• Newport Harbor Anesthesia Consultants Medical Group Inc
• Newport Harbor Cardiology Inc

• Family Medicine Physician in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2020; 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.