# DR SHANNA R NEWBOLD M D INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** SAN GORGONIO WOUND CARE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104541572
- **Authorized official:** SHANNA NEWBOLD MD (OWNER)
- **Authorized official phone:** (951) 381-2122

## Contact information

- **Practice address:** 264 N HIGHLAND SPRINGS AVE STE A, BANNING, CA 92220-3082
- **Practice address phone:** (951) 381-2122
- **Practice address fax:** (951) 561-7155
- **Mailing address:** 264 N HIGHLAND SPRINGS AVE STE A, BANNING, CA 92220-3082

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207P00000X | Emergency Medicine Physician | — | — | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/07/2022
- **Last updated:** 03/10/2026