Provider Demographics
NPI:1659301216
Name:WHITE, NEAL W JR (MD)
Entity Type:Individual
Prefix:DR
First Name:NEAL
Middle Name:W
Last Name:WHITE
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:106 LA CASA VIA STE 140
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-3084
Mailing Address - Country:US
Mailing Address - Phone:925-274-2860
Mailing Address - Fax:925-932-4527
Practice Address - Street 1:106 LA CASA VIA
Practice Address - Street 2:#140
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3086
Practice Address - Country:US
Practice Address - Phone:925-274-2860
Practice Address - Fax:925-932-4527
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2022-11-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG54732207R00000X, 207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D44630Medicare UPIN