Provider Demographics
NPI:1437442415
Name:NEWTON CHIROPRACTIC INC
Entity Type:Organization
Organization Name:NEWTON CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:J
Authorized Official - Last Name:NEWTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:562-795-7007
Mailing Address - Street 1:15550 ROCKFIELD BLVD
Mailing Address - Street 2:B220
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-2720
Mailing Address - Country:US
Mailing Address - Phone:949-598-9999
Mailing Address - Fax:949-598-9990
Practice Address - Street 1:2221 PALO VERDE AVE
Practice Address - Street 2:1J
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-2364
Practice Address - Country:US
Practice Address - Phone:949-795-7007
Practice Address - Fax:949-795-7009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-24
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC24891111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC24891AOtherINDIVIDUAL PTAN
CADC0248910OtherBLUE SHIELD INDIVIDUAL PIN
CADC24891OtherCHIROPRACTIC LICENSE
CA1649396052OtherINDIVIDUAL NPI