Provider Demographics
NPI:1144489592
Name:NEWMARK, JORDAN LEE (MD)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:LEE
Last Name:NEWMARK
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 1:7031 KOLL CENTER PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-3137
Mailing Address - Country:US
Mailing Address - Phone:925-469-9120
Mailing Address - Fax:925-469-9121
Practice Address - Street 1:7031 KOLL CENTER PKWY STE 100
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-3137
Practice Address - Country:US
Practice Address - Phone:925-469-9120
Practice Address - Fax:925-469-9121
Is Sole Proprietor?:No
Enumeration Date:2008-06-02
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA117497207L00000X, 207LP2900X, 208VP0014X
NY262294207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine