NPIMap

Organization Active NPI

Balboa Recovery

  • Point of Service
  • Newport Beach, CA
National Provider Identifier
1982957197
Registry record updated Oct 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Point of ServiceTaxonomy code 305S00000X
Legal business name
BALBOA RECOVERY
Practice address
3419 Via Lido
Newport Beach, CA 92663-3908
Phone
(949) 723-2388
NPI assigned
Oct 25, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2012

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

Authorized official

Name
Kevin Cullen
Title
Chief Executive Officer
Phone
(949) 400-7120

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Point of Service 305S00000X Primary

Addresses

Primary practice location

3419 Via Lido
Newport Beach, CA 92663-3908

Mailing address

204 21St St
Newport Beach, CA 92663-4372

National Provider Directory

National Provider Directory
Tax ID family
Balboa Recovery4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1351123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351123200000",
    "number": "1982957197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 21ST ST",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926634372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3419 VIA LIDO",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633908",
            "telephone_number": "949-723-2388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALBOA RECOVERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-25",
        "last_updated": "2012-10-25",
        "status": "A",
        "authorized_official_last_name": "CULLEN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "949-400-7120"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "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 Oct 25, 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.