Healthcare Provider Details

I. General information

NPI: 1174807507
Provider Name (Legal Business Name): WRIGHT INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2011
Last Update Date: 10/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2728 DURANT AVE
BERKELEY CA
94704-1725
US

IV. Provider business mailing address

2728 DURANT AVE
BERKELEY CA
94704-1725
US

V. Phone/Fax

Practice location:
  • Phone: 510-841-9230
  • Fax:
Mailing address:
  • Phone: 510-841-9230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number17179
License Number StateCA

VIII. Authorized Official

Name: DR. GILBERT NEWMAN
Title or Position: DIRECTOR OF CLINICAL TRAINING
Credential: PH.D
Phone: 510-841-9230