Newport Mesa Medical Group, Inc | |
275 Victoria St Ste 1e Costa Mesa CA 92627-1906 | |
(949) 574-3615 | |
Not Available |
Full Name | Newport Mesa Medical Group, Inc |
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Speciality | Internal Medicine |
Location | 275 Victoria St, Costa Mesa, California |
Authorized Official Name and Position | Abdul A Khan (OWNER PHYSICIAN) |
Authorized Official Contact | 9495743615 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Newport Mesa Medical Group, Inc 275 Victoria St Ste 1e Costa Mesa CA 92627-1906 Ph: (949) 574-3615 | Newport Mesa Medical Group, Inc 275 Victoria St Ste 1e Costa Mesa CA 92627-1906 Ph: (949) 574-3615 |
NPI Number | 1104836956 |
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Provider Enumeration Date | 08/08/2006 |
Last Update Date | 10/19/2010 |
Medicare PECOS PAC ID | 0547301509 |
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Medicare Enrollment ID | O20100113000149 |
Identifier | Type | State | Issuer |
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1104836956 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Abdul A Khan |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1932120797 PECOS PAC ID: 9436290491 Enrollment ID: I20101029000513 |
Provider Name | Munazza Khan |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1609897479 PECOS PAC ID: 5799826756 Enrollment ID: I20101029000565 |
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