Provider Demographics
NPI:1285657163
Name:NEW WEST MEDICAL, INC
Entity Type:Organization
Organization Name:NEW WEST MEDICAL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:GAVRAS
Authorized Official - Suffix:
Authorized Official - Credentials:RCP, LVN
Authorized Official - Phone:530-221-5864
Mailing Address - Street 1:2971 CHURN CREEK RD
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-1120
Mailing Address - Country:US
Mailing Address - Phone:530-221-5864
Mailing Address - Fax:530-221-1474
Practice Address - Street 1:2971 CHURN CREEK RD
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-1120
Practice Address - Country:US
Practice Address - Phone:530-221-5864
Practice Address - Fax:530-221-1474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45055332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA45055OtherMEDICAL DEVICES LICENSE
CADME0289FMedicaid
CADME0289FMedicaid