MEDICARE: MR. DANIEL NEWMARK M.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	237600000X	Audiologist-Hearing Aid Fitter	AU2441	CA

General Provider Information

NPI Number	:	1336327261
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DANIEL NEWMARK M.A.

Provider Business Mailing Address
First Line	:	750 N COMMONS DR STE 200
Second Line	:
City	:	AURORA
State	:	IL
Zip	:	60504-7940
Country	:	US
Telephone Number	:	630-303-5380
Fax Number	:	630-303-5385

Provider Business Practice Location Address
First Line	:	17135 VENTURA BLVD
Second Line	:
City	:	ENCINO
State	:	CA
Zip	:	91316-4004
Country	:	US
Telephone Number	:	818-986-1860
Fax Number	:	818-986-1862

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/01/2008
Last Update Date	:	05/19/2021

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