Provider Demographics
NPI:1982637815
Name:NEWTON, GREGORY K (DPT)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:K
Last Name:NEWTON
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:GREG
Other - Middle Name:K
Other - Last Name:NEWTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:337 S 10TH ST STE G
Mailing Address - Street 2:
Mailing Address - City:TAFT
Mailing Address - State:CA
Mailing Address - Zip Code:93268-3300
Mailing Address - Country:US
Mailing Address - Phone:661-763-4194
Mailing Address - Fax:661-763-5792
Practice Address - Street 1:337 S 10TH ST STE G
Practice Address - Street 2:
Practice Address - City:TAFT
Practice Address - State:CA
Practice Address - Zip Code:93268-3300
Practice Address - Country:US
Practice Address - Phone:661-763-4194
Practice Address - Fax:661-763-5792
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT21546225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ90568ZMedicare ID - Type UnspecifiedWESTERN
CA9171166Medicare UPIN
CAZZZ19077ZMedicare ID - Type UnspecifiedSOUTHCOAST