Newport Beach Colorectal Surgery Medical Group Inc

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

License

G70052 Issued in CA

Legal business name

NEWPORT BEACH COLORECTAL SURGERY MEDICAL GROUP INC

Practice address

1401 Avocado Ave
Ste 603
Newport Beach, CA 92660-7720

Phone

(949) 760-9431

Fax

(949) 760-0722

NPI assigned

Feb 26, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Daniel Allen NG, MD

Title

President

Phone

(949) 760-9431

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• KENNETH E AARON MD INC Former legal business name

Locations

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340150400000",
    "number": "1922134709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 AVOCADO AVE",
            "address_2": "STE 603",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607720",
            "telephone_number": "949-760-9431",
            "fax_number": "949-760-0722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 AVOCADO AVE",
            "address_2": "STE 603",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607720",
            "telephone_number": "949-760-9431",
            "fax_number": "949-760-0722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWPORT BEACH COLORECTAL SURGERY MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-26",
        "last_updated": "2012-06-20",
        "status": "A",
        "authorized_official_last_name": "NG",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-760-9431",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Colon & Rectal Surgery",
            "state": "CA",
            "license": "G70052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ47611Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G700520",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PIN",
            "identifier": "WG70052A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KENNETH E AARON MD INC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Newport Aesthetic Surgery Center LLC
• Newport Anesthesia Associates
• Newport Balboa Surgery Center, LLC
• Newport Bay Hospital
• Newport Bay Surgery Center, LLC
• Newport Beach Comprehensive Care Medical Group, Inc
• Newport Beach Endocrine Medical Group Inc
• Newport Beach Endoscopy Center, LLC
• Newport Beach Gastroenterology Assoc
• Newport Beach Hearing Aid Associates

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.