| Dr Shanna R Newbold M D Inc | |
|
350 Terracina Blvd Redlands CA 92373-4850 | |
| (909) 556-7694 | |
| Not Available |
| Full Name | Dr Shanna R Newbold M D Inc |
|---|---|
| Speciality | General Practice |
| Location | 350 Terracina Blvd, Redlands, California |
| Authorized Official Name and Position | Shanna Newbold (OWNER) |
| Authorized Official Contact | 9095567694 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Shanna R Newbold M D Inc 350 Terracina Blvd Redlands CA 92373-4850 Ph: () - | Dr Shanna R Newbold M D Inc 350 Terracina Blvd Redlands CA 92373-4850 Ph: (909) 556-7694 |
| NPI Number | 1104541572 |
|---|---|
| Provider Enumeration Date | 10/07/2022 |
| Last Update Date | 01/12/2023 |
| Medicare PECOS PAC ID | 3577934280 |
|---|---|
| Medicare Enrollment ID | O20230117001358 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104541572 | NPI | - | NPPES |
| 208D0000X | Other | TAXONOMY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Deborah L Behringer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1003094699 PECOS PAC ID: 3274600382 Enrollment ID: I20110105000745 |
| Provider Name | Shanna R Newbold |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1932407632 PECOS PAC ID: 1254516891 Enrollment ID: I20110426000598 |
| Provider Name | Sameh Mikhail |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265849723 PECOS PAC ID: 1052611639 Enrollment ID: I20170420001801 |
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