Healthcare Provider Details
I. General information
NPI: 1477832137
Provider Name (Legal Business Name): ANDREW B NEWMAN M D APC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/12/2011
Last Update Date: 04/02/2021
Certification Date: 04/02/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3351 EL CAMINO REAL STE 200
ATHERTON CA
94027-3802
US
IV. Provider business mailing address
3351 EL CAMINO REAL STE 200
ATHERTON CA
94027-3802
US
V. Phone/Fax
- Phone: 650-328-5222
- Fax: 650-324-4374
- Phone: 650-328-5222
- Fax: 650-324-4374
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RP1001X |
| Taxonomy | Pulmonary Disease Physician |
| License Number | G32075 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RS0010X |
| Taxonomy | Sports Medicine (Internal Medicine) Physician |
| License Number | G32075 |
| License Number State | CA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2083P0011X |
| Taxonomy | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician |
| License Number | G32075 |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
ANDREW
B.
NEWMAN
Title or Position: C.E.O.
Credential: M.D.
Phone: 650-328-5222