Provider Demographics
NPI:1376697797
Name:NEWMAN, MICHAEL S (DO)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:S
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4647 ZION AVE
Mailing Address - Street 2:KAISER PERMANENTE DEPARTMENT OF PULMONARY-CRITICAL CARE
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92120-2507
Mailing Address - Country:US
Mailing Address - Phone:619-528-5865
Mailing Address - Fax:619-528-3189
Practice Address - Street 1:4647 ZION AVE
Practice Address - Street 2:KAISER PERMANENTE DEPARTMENT OF PULMONARY-CRITICAL CARE
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92120-2507
Practice Address - Country:US
Practice Address - Phone:619-528-5865
Practice Address - Fax:619-528-3189
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA246136207RC0200X, 207RP1001X
CA20A 12416207RC0200X, 207RP1001X
WAOP60477657207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2039250Medicaid
CAW18762OtherGROUP MEDICARE
CAGR0100430OtherGROUP MEDI-CAL
CA1902846306OtherGROUP NPI
WA1790768547OtherGROUP NPI
WA1790768547OtherGROUP NPI