Basic Information
| Provider Information | |||||||||
| NPI: | 1649739616 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | NEWBY | ||||||||
| FirstName: | DART | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4276 KATELLA AVE UNIT 232 | ||||||||
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| City: | LOS ALAMITOS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 907203562 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1201 W LA VETA AVE | ||||||||
| Address2: | |||||||||
| City: | ORANGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92868 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7144565631 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/18/2019 | ||||||||
| LastUpdateDate: | 08/05/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/05/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | A180069 | CA | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.