Healthcare Provider Details

I. General information

NPI: 1912962044
Provider Name (Legal Business Name): GAIL JANZEN NEWEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS GAIL MARIE JANZEN

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 01/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 FULTON MALL
FRESNO CA
93721-1915
US

IV. Provider business mailing address

1221 FULTON MALL
FRESNO CA
93721-1915
US

V. Phone/Fax

Practice location:
  • Phone: 559-600-3200
  • Fax: 559-255-4210
Mailing address:
  • Phone: 559-600-3200
  • Fax: 559-255-4210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberG62822
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: