Provider Demographics
NPI:1447342415
Name:NEWMAN, MICHAEL (DC QME)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:DC QME
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1196 SOUTH DE ANZA BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129-3632
Mailing Address - Country:US
Mailing Address - Phone:408-996-8717
Mailing Address - Fax:498-996-8735
Practice Address - Street 1:1196 SOUTH DE ANZA BLVD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95129-3632
Practice Address - Country:US
Practice Address - Phone:408-996-8717
Practice Address - Fax:498-996-8735
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13625111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor