1922006451 NPI number — DR. FRANCISCO DELACRUZ-NEWLAN M.D.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922006451 NPI number — DR. FRANCISCO DELACRUZ-NEWLAN M.D.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

DELACRUZ-NEWLAN

Provider First Name:

FRANCISCO

Provider Middle Name:

Provider Name Prefix Text:

DR.

Provider Name Suffix Text:

Provider Credential Text:

M.D.

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1922006451

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

12/09/2022

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

1010 SYLVAN WAY

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

BREMERTON

Provider Business Mailing Address State Name:

WA

Provider Business Mailing Address Postal Code:

98310-2826

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

360-479-3657

Provider Business Mailing Address Fax Number:

360-373-7616

Provider First Line Business Practice Location Address:

1005 BROADWAY ST

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

QUINCY

Provider Business Practice Location Address State Name:

IL

Provider Business Practice Location Address Postal Code:

62301-2834

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

217-223-1200

Provider Business Practice Location Address Fax Number:

Provider Enumeration Date:

07/08/2005

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207L00000X , with the licence number:  2008009075 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 207L00000X , with the licence number: 036.099670 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 7215DE . This is a "REGENCE BLUE SHIELD" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
• Identifier: 8366148 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
• Identifier: 910847215 . This is a "UNIFORM MEDICAL" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
• Identifier: 016487001 . This is a "GROUP HEALTH CORP" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
• Identifier: 910847215 . This is a "PREMERA BLUE CROSS" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
• Identifier: P00055294 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
• Identifier: A035 . This is a "TRIWEST (CHAMPUS)" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
• Identifier: 0172507 . This is a "LABOR AND INDUSTRIES" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
• Identifier: 910847215-36 . This is a "KPS NUMBER" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
• Identifier: 8932656 . This is a "VICTIMS OF CRIME" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".