Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | A055188 | CA |
N | 207SG0201X | Clinical Genetics (M.D.) | A055188 | CA |
NPI | 1568433274 |
---|---|
Provider Name | Glenn Nathan Newman |
First Address | Torrance, CA 90505-2507 |
Second Address | Torrance, CA 90505-2507 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2006 |
Last Update Date | 16/11/2010 |