Healthcare Provider Details

I. General information

NPI: 1043390214
Provider Name (Legal Business Name): RICHARD S NEWMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 03/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UCI MEDICAL CENTER 101 THE CITY DRIVE SOUTH
ORANGE CA
92868
US

IV. Provider business mailing address

UCI DEPARTMENT OF PATHOLOGY PO BOX 513377
LOS ANGELES CA
90051-3377
US

V. Phone/Fax

Practice location:
  • Phone: 714-456-2986
  • Fax:
Mailing address:
  • Phone: 714-456-2986
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License Number000000G45675
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: