| Newport Neurology | |
|
360 San Miguel Dr Ste 503 Newport Beach CA 92660-7831 | |
| (949) 760-1640 | |
| (949) 760-1610 |
| Full Name | Newport Neurology |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 360 San Miguel Dr Ste 503, Newport Beach, California |
| Authorized Official Name and Position | Steven Wheeler (PRESIDENT) |
| Authorized Official Contact | 9497601640 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Newport Neurology 1401 Avocado Ave Suite 805 Newport Beach CA 92660-7720 Ph: (949) 760-1640 | Newport Neurology 360 San Miguel Dr Ste 503 Newport Beach CA 92660-7831 Ph: (949) 760-1640 |
| NPI Number | 1912028176 |
|---|---|
| Provider Enumeration Date | 04/03/2007 |
| Last Update Date | 09/19/2024 |
| Certification Date | 09/19/2024 |
| Medicare PECOS PAC ID | 7911940986 |
|---|---|
| Medicare Enrollment ID | O20050609001167 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912028176 | NPI | - | NPPES |
| 00G793770 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Steven W Wheeler |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1225180615 PECOS PAC ID: 1951565167 Enrollment ID: I20120619000191 |
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