Healthcare Provider Details

I. General information

NPI: 1275800906
Provider Name (Legal Business Name): NEWTON MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2011
Last Update Date: 11/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 GRAND AVE SUITE 100
OAKLAND CA
94612-3741
US

IV. Provider business mailing address

180 GRAND AVE SUITE 100
OAKLAND CA
94612-3741
US

V. Phone/Fax

Practice location:
  • Phone: 510-208-4700
  • Fax: 510-208-4710
Mailing address:
  • Phone: 510-208-4700
  • Fax: 510-208-4710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State

VIII. Authorized Official

Name: MRS. CORRINNE GOLDBERG
Title or Position: SENIOR DIRECTOR
Credential:
Phone: 510-208-4700