Provider Demographics
NPI:1336708064
Name:NEWMAN, GABRIELLA (DO)
Entity type:Individual
Prefix:
First Name:GABRIELLA
Middle Name:
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9150 WILSHIRE BLVD # 105
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-3427
Mailing Address - Country:US
Mailing Address - Phone:310-402-8997
Mailing Address - Fax:
Practice Address - Street 1:9150 WILSHIRE BLVD # 105
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-3427
Practice Address - Country:US
Practice Address - Phone:310-402-8997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-06
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A19368261QH0100X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth ServiceGroup - Single Specialty