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General NPI Number Information
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NPI Number | 1962663021
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Entity Type | Organization
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Legal Business Name | WALTER S. NEWMAN, JR., M.D. A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 06/21/2008
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Last Update Date | 05/07/2012
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Provider Practice Location Address
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Address Line | 6950 SANTA TERESA BLVD SUITE B
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City | SAN JOSE
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State | CA
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Zip | 95119-1300
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Country | US
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Telephone | 408-226-5400
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Fax | 408-226-1817
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Provider Business Mailing Address
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Address Line | 6950 SANTA TERESA BLVD SUITE B
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City | SAN JOSE
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State | CA
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Zip | 95119-1300
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Country | US
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Telephone | 408-226-5400
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Fax | 408-226-1817
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WALTER SIMON NEWMAN JR.
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Credential | M.D.
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Telephone | 408-226-5400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | G39525
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License Number State | CA
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