| Newport Center Medical Group | |
|
400 Newport Center Dr Suite 504 Newport Beach CA 92660-7601 | |
| (949) 720-4920 | |
| (949) 720-4928 |
| Full Name | Newport Center Medical Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 400 Newport Center Dr, Newport Beach, California |
| Authorized Official Name and Position | Ronald Mark Tilsen (MANAGING PARTNER) |
| Authorized Official Contact | 9497204920 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Newport Center Medical Group 400 Newport Center Dr Suite 504 Newport Beach CA 92660-7601 Ph: (949) 720-4920 | Newport Center Medical Group 400 Newport Center Dr Suite 504 Newport Beach CA 92660-7601 Ph: (949) 720-4920 |
| NPI Number | 1467478008 |
|---|---|
| Provider Enumeration Date | 07/15/2006 |
| Last Update Date | 08/25/2015 |
| Medicare PECOS PAC ID | 7618911215 |
|---|---|
| Medicare Enrollment ID | O20050614001496 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467478008 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Primary |
| Provider Name | Stephen H Nguyen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619976644 PECOS PAC ID: 7416979109 Enrollment ID: I20060227000778 |
| Provider Name | Sevitlana Safaei |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013065812 PECOS PAC ID: 2961416821 Enrollment ID: I20090120000038 |
| Provider Name | Syed S Naqvi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659567733 PECOS PAC ID: 0749334258 Enrollment ID: I20090818000815 |
| Provider Name | Ramin I Alizadeh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659427235 PECOS PAC ID: 5991841975 Enrollment ID: I20091005000557 |
| Provider Name | Ronald Mark Tilsen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801852280 PECOS PAC ID: 3274657192 Enrollment ID: I20101118000610 |
| Provider Name | Bradley William Kays |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417914334 PECOS PAC ID: 8628192549 Enrollment ID: I20101118000754 |
| Provider Name | William Fukuda |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396701850 PECOS PAC ID: 3173647096 Enrollment ID: I20101118001261 |
| Provider Name | Amy Teresi |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1265498703 PECOS PAC ID: 0446374367 Enrollment ID: I20101118001303 |
| Provider Name | Susan Cederstrom |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578529012 PECOS PAC ID: 1254455173 Enrollment ID: I20101118001337 |
| Provider Name | Anna V Ottaka |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154613685 PECOS PAC ID: 0446402176 Enrollment ID: I20121204000253 |
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