Provider Demographics
NPI:1538221932
Name:NEWMAN, MARK A (DC)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:A
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 N MAGNOLIA AVE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-2638
Mailing Address - Country:US
Mailing Address - Phone:714-220-0520
Mailing Address - Fax:714-220-0582
Practice Address - Street 1:1125 N MAGNOLIA AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-2638
Practice Address - Country:US
Practice Address - Phone:714-220-0520
Practice Address - Fax:714-220-0582
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 27825111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA203898700OtherOWCP