Provider Demographics
NPI:1316268709
Name:NEWTON, REGINALD BRUCE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:REGINALD
Middle Name:BRUCE
Last Name:NEWTON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:888 LINCOLN BLVD
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:CA
Mailing Address - Zip Code:90291-2866
Mailing Address - Country:US
Mailing Address - Phone:310-396-2838
Mailing Address - Fax:310-396-0578
Practice Address - Street 1:888 LINCOLN BLVD
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:CA
Practice Address - Zip Code:90291-2866
Practice Address - Country:US
Practice Address - Phone:310-396-2838
Practice Address - Fax:310-396-0578
Is Sole Proprietor?:No
Enumeration Date:2010-06-19
Last Update Date:2010-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH24681183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist