Basic Information
Provider Information
NPI: 1902089543
EntityType: 2
ReplacementNPI:  
OrganizationName: THE WRIGHT INSTITUTE
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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Mailing Information
Address1: 1918 UNIVERSITY AVE
Address2: SUITE 2B, 3A
City: BERKELEY
State: CA
PostalCode: 947043264
CountryCode: US
TelephoneNumber: 5108419230
FaxNumber:  
Practice Location
Address1: 1918 UNIVERSITY AVE
Address2: SUITE 2B, 3A
City: BERKELEY
State: CA
PostalCode: 947043264
CountryCode: US
TelephoneNumber: 5108419230
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/05/2007
LastUpdateDate: 03/24/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: NEWMAN
AuthorizedOfficialFirstName: GILBERT
AuthorizedOfficialMiddleName: H
AuthorizedOfficialTitleorPosition: DIRECTOR OF CLINICAL TRAINING
AuthorizedOfficialTelephone: 5108419230
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: PROF.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: PHD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261Q00000X140000166CAY Ambulatory Health Care FacilitiesClinic/Center 

No ID Information.


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