Healthcare Provider Details

I. General information

NPI: 1023376936
Provider Name (Legal Business Name): NEWTON AGRAWAL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2012
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10737 CAMINO RUIZ STE 235
SAN DIEGO CA
92126-2375
US

IV. Provider business mailing address

637 3RD AVE STE E1
CHULA VISTA CA
91910-5707
US

V. Phone/Fax

Practice location:
  • Phone: 844-200-2426
  • Fax: 619-474-4008
Mailing address:
  • Phone: 844-200-2426
  • Fax: 619-356-2726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME140097
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberC189669
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberNONE
License Number StateTN
# 4
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberNONE
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: