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NPI Code Detail

MEDICARE: DR. EMILY CLARA NEWSOM M.D.

MEDICARE: DR. EMILY CLARA NEWSOM M.D.
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
1207N00000XDermatology PhysicianA142707CA
2207NS0135XProcedural Dermatology PhysicianA142707CA
3207ND0101XMOHS-Micrographic Surgery PhysicianA142707CA

General Provider Information

NPI Number : 1639460744
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EMILY CLARA NEWSOM M.D.
Provider Business Mailing Address
First Line : 5767 W CENTURY BLVD STE 400
Second Line :
City : LOS ANGELES
State : CA
Zip : 90045-5631
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 27235 TOURNEY RD STE 2500
Second Line :
City : VALENCIA
State : CA
Zip : 91355-5908
Country : US
Telephone Number : 661-253-5851
Fax Number : 661-253-5852
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/22/2011
Last Update Date : 09/05/2019

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