Newport Coast Pathology, Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

G74263 Issued in CA

Legal business name

NEWPORT COAST PATHOLOGY, INC.

Practice address

27 Clermont
Newport Beach, CA 92657-1069

Phone

(949) 706-2796

Fax

(949) 706-2072

NPI assigned

Apr 30, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Mani Ehteshami, M.D., M.S.

Title

Medical Director and President

Phone

(888) 463-3606

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1272585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320105600000",
    "number": "1922325877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 CLERMONT",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926571069",
            "telephone_number": "949-706-2796",
            "fax_number": "949-706-2072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 CLERMONT",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926571069",
            "telephone_number": "949-706-2796",
            "fax_number": "949-706-2072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWPORT COAST PATHOLOGY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-30",
        "last_updated": "2011-11-01",
        "status": "A",
        "authorized_official_last_name": "EHTESHAMI",
        "authorized_official_first_name": "MANI",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR AND PRESIDENT",
        "authorized_official_telephone_number": "888-463-3606",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D., M.S."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "G74263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Newport Children'S Medical Group
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• Newport Coast Dermatology
• Newport Coast Outpatient Surgery Center
• Newport Coast Plastic Surgery, a Medical Corporation
• Newport Coast Radiation Oncology Medical Group, Inc
• Newport Coast Recovery
• Newport Coast Surgery Center, LP
• Newport Coast Surgical and Pain Center, LLC

• Clinical Medical Laboratory in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Clinical Medical Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2011; 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.