Provider Demographics
NPI:1962622605
Name:NEWMAN, MICHAEL (BC-HIS, ACA)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:BC-HIS, ACA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27141 LERMA
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-2103
Mailing Address - Country:US
Mailing Address - Phone:949-458-6153
Mailing Address - Fax:562-985-0225
Practice Address - Street 1:1777 N BELLFLOWER BLVD STE 105
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-4019
Practice Address - Country:US
Practice Address - Phone:562-494-7224
Practice Address - Fax:562-985-0225
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA3390174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist