Provider Demographics
NPI:1043307846
Name:NEWCOMB, CURTIS VICTOR (OD)
Entity Type:Individual
Prefix:
First Name:CURTIS
Middle Name:VICTOR
Last Name:NEWCOMB
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 EUREKA WAY # A
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-0815
Mailing Address - Country:US
Mailing Address - Phone:530-241-9650
Mailing Address - Fax:
Practice Address - Street 1:1225 EUREKA WAY # A
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-0815
Practice Address - Country:US
Practice Address - Phone:530-241-9650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12455T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA202366466OtherEIN
CASD0124550Medicare PIN
CA202366466OtherEIN
CAU82270Medicare UPIN