Healthcare Provider Details

I. General information

NPI: 1972569887
Provider Name (Legal Business Name): SIOBHAN NEWMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2006
Last Update Date: 09/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5505 COLOMA CIR
SIMI VALLEY CA
93063-5029
US

IV. Provider business mailing address

5505 COLOMA CIR
SIMI VALLEY CA
93063-5029
US

V. Phone/Fax

Practice location:
  • Phone: 805-579-3981
  • Fax:
Mailing address:
  • Phone: 805-579-3981
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA68673
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA68673
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: