Provider Demographics
NPI:1992757603
Name:NEUMAN, THOMAS (PODIATRIST)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:NEUMAN
Suffix:
Gender:M
Credentials:PODIATRIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9017 RESEDA BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-3922
Mailing Address - Country:US
Mailing Address - Phone:818-885-8400
Mailing Address - Fax:818-885-5765
Practice Address - Street 1:1672 W AVENUE J
Practice Address - Street 2:STE 201
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-2861
Practice Address - Country:US
Practice Address - Phone:818-885-8400
Practice Address - Fax:818-885-5765
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE1584213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E15842Medicaid
CA953525316OtherEIN
CAE1584BMedicare ID - Type UnspecifiedMEDICARE
CAT11002Medicare UPIN
CA0794160001Medicare NSC
CA0794160002Medicare NSC