Basic Information
Provider Information
NPI: 1740383611
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NEWTH
FirstName: CHRISTOPHER
MiddleName: J.L
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6430 W SUNSET BLVD
Address2: SUITE 600
City: LOS ANGELES
State: CA
PostalCode: 900287901
CountryCode: US
TelephoneNumber: 3233612337
FaxNumber: 3236448488
Practice Location
Address1: 4650 W SUNSET BLVD
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900276062
CountryCode: US
TelephoneNumber: 3233612557
FaxNumber: 3233610728
Other Information
ProviderEnumerationDate: 09/06/2006
LastUpdateDate: 08/20/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0200XA38570CAY Allopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine

ID Information
IDTypeStateIssuerDescription
00A38570205CA MEDICAID


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