=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194031492
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CHERYL NEWMAN MD, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/24/2010
-----------------------------------------------------
Last Update Date | 10/10/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2510 MONTEREY ST UNIT 3341
-----------------------------------------------------
City | TORRANCE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90510-0418
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 585-395-1111
-----------------------------------------------------
Fax | 585-395-1116
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2510 MONTEREY ST UNIT 3341
-----------------------------------------------------
City | TORRANCE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90510-0418
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 585-395-1111
-----------------------------------------------------
Fax | 585-395-1116
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. CHERYL A NEWMAN
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 585-395-1111
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 242361
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------