Basic Information
| Provider Information | |||||||||
| NPI: | 1770685836 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HOWARD K NEWMAN, M.D., INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 412 W CARROLL AVE | ||||||||
| Address2: | SUITE 106 | ||||||||
| City: | GLENDORA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917414240 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6269636026 | ||||||||
| FaxNumber: | 6269635094 | ||||||||
| Practice Location | |||||||||
| Address1: | 412 W CARROLL AVE | ||||||||
| Address2: | SUITE 106 | ||||||||
| City: | GLENDORA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917414240 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6269636026 | ||||||||
| FaxNumber: | 6269635094 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/01/2006 | ||||||||
| LastUpdateDate: | 08/31/2010 | ||||||||
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| AuthorizedOfficialLastName: | NEWMAN | ||||||||
| AuthorizedOfficialFirstName: | HOWARD | ||||||||
| AuthorizedOfficialMiddleName: | K | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 6269636026 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | C34941 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 00C349411 | 05 | CA | MEDICAID |