Provider Demographics
NPI:1023121787
Name:NEWMAN, DONALD (MD)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BAYWOOD AVENUE
Mailing Address - Street 2:STE. 7
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94402-1537
Mailing Address - Country:US
Mailing Address - Phone:650-344-6961
Mailing Address - Fax:
Practice Address - Street 1:345 LORTON AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-4133
Practice Address - Country:US
Practice Address - Phone:650-343-0741
Practice Address - Fax:650-697-0645
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA186862084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A186860Medicare ID - Type Unspecified