Provider Demographics
NPI:1669458394
Name:NEWMAN, ALAN
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2340 CLAY ST FL 7
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-1932
Mailing Address - Country:US
Mailing Address - Phone:415-600-5959
Mailing Address - Fax:
Practice Address - Street 1:601 DUBOCE AVE STE 250
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-3389
Practice Address - Country:US
Practice Address - Phone:415-600-5959
Practice Address - Fax:415-369-1392
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG1314572084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCP00706931OtherRAILROAD MEDICARE
CAG131457OtherSTATE MEDICAL LICENSE
G18511Medicare UPIN