Provider Demographics
NPI:1114114949
Name:DAVID L. NEUMANN, MD., A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:DAVID L. NEUMANN, MD., A PROFESSIONAL CORPORATION
Other - Org Name:HEALTHSHARE MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:NEUMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-325-6621
Mailing Address - Street 1:PO BOX 2539
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92263-2539
Mailing Address - Country:US
Mailing Address - Phone:760-325-6621
Mailing Address - Fax:760-325-3927
Practice Address - Street 1:555 E TACHEVAH DR
Practice Address - Street 2:SUITE 2W-105
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-5750
Practice Address - Country:US
Practice Address - Phone:760-325-6621
Practice Address - Fax:760-325-3927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-25
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG27957207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ16613ZMedicare PIN