Provider Demographics
NPI:1851604664
Name:ABIGAIL JONES- NEWSOME
Entity Type:Organization
Organization Name:ABIGAIL JONES- NEWSOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:ABIGAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES-NEWSOME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-433-3713
Mailing Address - Street 1:2530 VISTA WAY
Mailing Address - Street 2:# F113
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-6174
Mailing Address - Country:US
Mailing Address - Phone:760-433-3713
Mailing Address - Fax:760-433-3153
Practice Address - Street 1:2249 S EL CAMINO REAL
Practice Address - Street 2:# D
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-6392
Practice Address - Country:US
Practice Address - Phone:760-433-3713
Practice Address - Fax:760-433-3153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-21
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies