| Newport Personal Medicine, Inc. | |
|
22 Odyssey Ste 110 Irvine CA 92618-3186 | |
| (949) 500-5662 | |
| (949) 706-9440 |
| Full Name | Newport Personal Medicine, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 22 Odyssey Ste 110, Irvine, California |
| Authorized Official Name and Position | Robert Stephen Jennings (PRESIDENT) |
| Authorized Official Contact | 9495005662 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Newport Personal Medicine, Inc. P.o. Box 11807 Newport Beach CA 92658 Ph: (949) 500-5662 | Newport Personal Medicine, Inc. 22 Odyssey Ste 110 Irvine CA 92618-3186 Ph: (949) 500-5662 |
| NPI Number | 1336650068 |
|---|---|
| Provider Enumeration Date | 10/20/2017 |
| Last Update Date | 01/04/2018 |
| Medicare PECOS PAC ID | 6800138629 |
|---|---|
| Medicare Enrollment ID | O20190426002118 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336650068 | NPI | - | NPPES |
| Provider Name | Robert S Jennings |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932211380 PECOS PAC ID: 2062489743 Enrollment ID: I20040913000770 |
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