Provider Demographics
NPI:1275800906
Name:NEWTON MEDICAL GROUP
Entity Type:Organization
Organization Name:NEWTON MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CORRINNE
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-208-4700
Mailing Address - Street 1:180 GRAND AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-3741
Mailing Address - Country:US
Mailing Address - Phone:510-208-4700
Mailing Address - Fax:510-208-4710
Practice Address - Street 1:180 GRAND AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-3741
Practice Address - Country:US
Practice Address - Phone:510-208-4700
Practice Address - Fax:510-208-4710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-23
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Multi-Specialty