=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861548109
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | STEVEN DOUGLAS NEWTON P.T.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/27/2007
-----------------------------------------------------
Last Update Date | 06/29/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2001 W ALAMEDA AVE
-----------------------------------------------------
City | BURBANK
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91506-2932
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-953-4444
-----------------------------------------------------
Fax | 818-953-4940
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10040 MERITAGE CT
-----------------------------------------------------
City | SUN VALLEY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91352-4203
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 909-957-9357
-----------------------------------------------------
Fax | 818-351-0164
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | PT15811
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------