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General NPI Number Information
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NPI Number | 1033218706
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Entity Type | Organization
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Legal Business Name | NEWSOME MEDICAL
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2588 PROGRESS ST STE 1
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City | VISTA
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State | CA
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Zip | 92081-8443
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Country | US
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Telephone | 760-599-1170
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Fax |
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Provider Business Mailing Address
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Address Line | 6965 EL CAMINO REAL # 105-529
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City | CARLSBAD
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State | CA
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Zip | 92009-4100
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Country | US
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Telephone | 760-599-1170
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALLEN NEWSOME
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Credential |
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Telephone | 760-599-1170
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 14630
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License Number State | CA
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