NPIMap

Organization Active NPI

Harbor Pediatric Medical Group

  • Pediatrics Physician
  • Newport Beach, CA
National Provider Identifier
1922015072
Registry record updated Jan 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
HARBOR PEDIATRIC MEDICAL GROUP
Practice address
601 Dover Dr Ste 7
Newport Beach, CA 92663-5721
Phone
(949) 465-4670
Fax
(949) 722-6866
NPI assigned
Aug 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2012

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

Authorized official

Name
David Anthony Michelis, MDNPI 1912984741
Title
Owner
Phone
(949) 645-4670

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary
Clinic/Center 261Q00000X CA

Addresses

Primary practice location

601 Dover Dr Ste 7
Newport Beach, CA 92663-5721

Mailing address

601 Dover Dr Ste 7
Newport Beach, CA 92663-5721

National Provider Directory

National Provider Directory

Locations

601 Dover Dr
Ste 7
Newport Beach, CA 92663
Phone (949) 465-4670

601 Dover Dr
Newport Beach, CA 92663

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326240000000",
    "number": "1922015072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 DOVER DR STE 7",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926635721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 DOVER DR STE 7",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926635721",
            "telephone_number": "949-465-4670",
            "fax_number": "949-722-6866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBOR PEDIATRIC MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-02",
        "last_updated": "2012-01-11",
        "status": "A",
        "authorized_official_last_name": "MICHELIS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-645-4670",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2012; 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.